Arthritis drug shows promise in treating COVID-19
Courtesy of Metro Creative
A new study in the Journal of the American Medical Association’s Internal Medicine shows the drug tocilizumab has shown it can help if given to critically ill COVID-19 patients within two days of being admitted to intensive care.
Dr. Tariq Cheema
A drug normally used as a treatment for arthritis is now showing promise in saving the lives of patients who are critically ill with COVID-19.
A new study shows the drug tocilizumab has shown it can help if given to critically ill COVID-19 patients within two days of being admitted to intensive care. Tocilizumab is an immune modulator that is used to treat rheumatoid arthritis.
A clinical study published in the Journal of the American Medical Association’s Internal Medicine showed it helped cut the number of deaths in patients from 37% to 27%. More than 67 hospitals participated in the study which tracked nearly 4,000 patients.
According to the study, critically ill patients with coronavirus disease have short-term mortality rates ranging from 35% to as high as 50-62% depending on various factors including age and other medical conditions. The idea behind the study was to examine how treatments targeting a patient’s immune response to infection can potentially lower inflammation and improve outcomes in patients with severe COVID-19 illness.
How does it work?
Tocilizumab is what’s called a monoclonal antibody which helps prevent patients’ immune systems from overreacting because of fighting the COVID-19 virus. The study shows it proved very effective in helping patients if given within two to three days of being admitted to the ICU with COVID-19 symptoms.
It’s one of many drugs doctors are using to fight the virus and researchers say it helps fight inflammation in the same way as steroids, but on a more targeted scale.
Tocilizumab is administered intravenously in either one or two doses. Local doctors say the news is encouraging.
“The results are promising but more studies are needed before we can say that the drug is ready for prime time,” says Dr. Tariq Cheema, division chief of Pulmonary and Critical Care for Allegheny Health Network. “The study has not been published in a peer review journal and the jury is still out. The early data shows that it improved mortality when used early in the course of severe COVID illness.”
President Donald Trump received treatment with antibody therapy during his bout with COVID-19, but Dr. Cheema said tocilizumab is different.
“It is a monoclonal antibody that specifically blocks IL-6 which is the biggest culprit responsible for the so called ‘cytokine storm,'” he said. “The human body has an exaggerated immune response to COVID and sometimes it will go unchecked and causes more harm than good. IL-6 is a chemical released by the immune system that specifically drives this response and tocilizumab helps inhibit its release.”
Tocilizumab was originally developed to treat juvenile rheumatoid arthritis which is an autoimmune disease in which exaggerated immune responses destroy joints.
Trump received an antibody cocktail called Regeneron, which was a combination of two antibody therapies.
“One is derived from patients who were infected with COVID-19 and then replicated to produce more antibodies,” Cheema said, “and the second antibody comes from mice who were infected with COVID-19 and then replicated for mass production.”
Both of these antibodies have a direct effect on the SAR-CoV2 virus that causes COVID-19.
One of many tools
The arthritis drug is just another tool for doctors to use in fighting the virus.
Cheema said doctors at AHN are using dexamethasone, remdesivir and convalescent plasma on all eligible patients and tocilizumab was used as part of a clinical trial in which he was an investigator.
How do doctors know which drug will help which patients?
“A team of physicians from Pulmonary Critical Care and Infectious disease developed a treatment algorithm that helps guide our physicians on what drugs and therapies to use,” Cheema said. “We are seeing better outcomes in general but the jury is still out whether it’s the therapies that are working or are we just seeing younger and healthier patients getting ill and they tend to have a better outcome than older and sicker patients.”
While some of the results of this study were encouraging, there’s still so much that is unknown about COVID-19 and how to treat it.
Cheema said even though news of a potentially effective vaccine have lifted everyone’s hopes, our best defense is still prevention.
“Three simple things: Wear a mask, social distance, wash your hands,” he said. “The vaccines are coming but we have a long way to get back to normal and we all have our part to play to make sure we get through this.”