An international study has shown that treating critically ill Covid-19 patients with medicines typically used for arthritis may significantly improve survival.
Patients, researchers and clinicians at Leicester’s Hospitals contributed important data to the REMAP-CAP trial which evaluates the effect of treatments on survival rates and the length of time patients need support in an intensive care unit (ICU). Leicester’s Hospitals are in the top three centres for recruitment in the UK, with over 100 patients in Leicester joining this urgent public health study.
Initial findings reported back in November by Imperial College London and the Intensive Care National Audit & Research Centre (ICNARC) showed that tocilizumab, a drug usually used to treat arthritis, was likely to improve outcomes for patients critically ill with Covid-19. However, the impact on patient survival and length of time on organ support in ICU was not yet clear.
The latest analysis* shows that tocilizumab and a second drug called sarilumab have a significant impact on patient survival, reducing the relative risk of death by 24 per cent, when administered to patients within 24 hours of entering intensive care.
Furthermore, the treatment also improved recovery so that, on average, patients were able to be discharged from the intensive care unit (ICU) about a week earlier.
The government has welcomed the findings and asked that all NHS trusts begin to prescribe tocilizumab and sarilumab as standard care within 24 hours of a patient being admitted to ICU with COVID-19, with immediate effect.
Dr Hafiz Qureshi, a consultant haematologist and co-principal investigator for the REMAP-CAP clinical trial at Leicester’s Hospitals, said: “This finding is great news for our sickest patients with Covid-19 who require breathing support in intensive care units, as treatment with tocilizumab and sarilumab can improve their chances of survival and recovery.
“Together with the earlier finding that dexamethasone increases survival rate in patients with COVID-19, and the roll out of vaccines to help prevent the spread of coronavirus, it is another step towards overcoming this disease.”
Dr Hakeem Yusuff, a consultant in intensive care medicine and co-principal investigator for the REMAP-CAP clinical trial at Leicester’s Hospitals, said: “Tocilizumab and sarilumab are medicines used to treat rheumatoid arthritis. They work by ‘dampening’ an over-reactive immune system, which is something we are often seeing in patients hospitalised with COVID-19. The trial showed that patients receiving either tocilizumab or sarilumab were more likely to spend less time on organ support, such as on a ventilator, compared to patients who did not receive either medicine.”
Dr Neil Flint, a consultant in intensive care medicine and co-investigator for the REMAP-CAP clinical trial at Leicester’s Hospitals, said: “It really is very exciting to see such positive results and I would like to thank all the patients and their families who agreed to participate in the trial. Their help means we can potentially save more lives.”
In total, over 4,100 patients in 15 countries have been enrolled into the REMAP-CAP trial at more than 290 hospitals worldwide. Over 3,100 of these were recruited in the UK. The REMAP-CAP trial is supported in the UK by the National Institute for Health Research (NIHR).
UHL News released dated 12/01/21