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A new study found that the arthritis drug tocilizumab could not beat the standard treatment for severe COVID-19.

SARS-CoV-2 (shown here as an electron microscope image). Credits: National Institute of Allergy and Infectious Diseases, NIH

Adding the arthritis drug tocilizumab to the standard treatment of inpatients with severe or severe COVID-19 is superior to standard treatment alone in improving clinical outcomes at 15 days. BMJ today.

Patients receiving tocilizumab had an increased number of deaths in 15 days and the study was discontinued early.

Today’s results are inconsistent with previous observational studies suggesting the benefits of tocilizumab. However, the observation effect is limited by the high risk that it may be due to other unknown (confounding) factors. Some studies have not yet been peer-reviewed or published in medical journals.

A randomized trial evaluating tocilizumab in critically ill patients with COVID-19 (REMAP-CAP), published earlier this month as a preprint, found beneficial effects of the drug on days without organ support and mortality within 21 days. Found. The reasons for these clearly contradictory effects, such as differences in patient characteristics, need to be evaluated in future analyzes, the researchers say.

Tocilizumab blocks certain parts of the immune system (interleukin 6) that can enter overdrive in some patients with COVID-19. Doctors believe that this may help reduce the body’s inflammatory response to the virus and avoid some of the more disastrous consequences of the disease, but its effects are not well defined.

To test this theory, Brazil-based researchers conducted a randomized controlled trial comparing only tocilizumab with standard treatment in patients admitted with severe or severe COVID-19.

Their findings are based on 129 relatively young adults (mean age 57 years) with COVID-19 confirmed in nine Brazilian hospitals between May 8 and July 17, 2020. I will.

The patient was on oxygenation or mechanical ventilation and had abnormal levels of at least two chemicals associated with blood inflammation.

Patients were randomly divided into two groups: 65 received tocilizumab and standard treatment, and 64 received only standard treatment.

All patients were monitored for 15 days, taking into account other potentially important factors such as underlying illness and the use of other drugs.

By day 15, 18 (28%) patients in the tocilizumab group and 13 (20%) in the standard-treatment group had been ventilated or died.

Deaths at 15 days occurred in 11 patients (17%) in the tocilizumab group, compared with 2 patients (3%) in the standard-treatment group.

Increased mortality in the tocilizumab group raised safety concerns and the trial was discontinued early. In both groups, death was due to COVID-19-related acute respiratory failure or multiple organ failure.

Researchers have pointed out some limitations, including small sample sizes, that affect the likelihood of detecting the true effect. However, the results after adjusting the level of respiratory support required by the patient at the start of the study are consistent, suggesting that the findings are scrutinized.

As a result, researchers found that in severely or severely ill COVID-19 patients, “tocilizumab and standard treatment are not superior to standard treatment alone in improving clinical status at 15 days and may increase mortality. There is. “

And they state that these results “raise questions about anti-inflammatory approaches in the treatment of COVID-19 beyond corticosteroids.”


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For more information:
Effect of Tocilizumab on Clinical Outcomes after 15 Days in Patients with Severe or Severe Coronavirus Diseases in 2019: Randomized Controlled Trials, BMJ (2021). DOI: 10.1136 / bmj.n84

Provided by British Medical Journal

Quote: In a new study, the arthritis drug tocilizumab was obtained from https://medicalxpress.com/news/2021-01-trial-arthritis-drug-tocilizumab- on January 20, 2021 for severe COVID-19 (2021). Found not to be better than standard treatment (January 20, 2014) standard.html

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A new study found that the arthritis drug tocilizumab could not beat the standard treatment for severe COVID-19.

Source link A new study found that the arthritis drug tocilizumab could not beat the standard treatment for severe COVID-19.

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