Arthritis Drug Approved for Critically Ill COVID Patients

WRITTEN BY: Tara Fernandes

Critically ill COVID patients in the U.K. may receive an arthritis drug after a study showed that treatment lowered mortality rates and accelerated recovery times in intensive care.

The drug tocilizumab (Actemra) is an approved biologic medication for the treatment of rheumatoid arthritis. The drug works by blocking the inflammatory protein interleukin-6, or IL-6, to calm arthritis-induced joint swelling, pain, and other symptoms caused by inflammation.

Researchers at the Imperial College London found that tocilizumab was also able to help COVID patients, reducing the mortality rate in critically ill individuals by around 10 percent and, on average, shortening their hospital stays by a week.

With the pandemic raging on in the new year, the list of existing treatments that have been tested to help COVID patients continues to grow. Unfortunately, except for the steroid treatment dexamethasone, few have been successful.

Once the SARS-CoV-2 virus enters the body, infection typically manifests as influenza-like symptoms: cough, fever, and headaches. A subset of infected individuals spirals quickly into a state of potentially lethal hypoxemic respiratory failure—a condition caused by a massive surge of inflammatory factors in the body. These patients have markedly abnormal levels of IL-6, ferritin, and C-reactive proteins, among other molecules associated with the “cytokine storm.”

Tocilizumab’s life-saving effects are likely attributed to the drug’s ability to quench inflammation, specifically targeting IL-6. High circulating concentrations of this pro-inflammatory protein are associated with uncontrolled viral replication, a rapid decline in respiratory health, resulting in the need for mechanical ventilation, and even death. This led researchers to hypothesize that blocking IL-6 can help patients by halting the inflammatory cascade.

The report from the REMAP-CAP trial indicates that the scientists may be on the right track. The ongoing clinical trial has enrolled nearly 4,000 patients in the U.K., with 350 of them receiving tocilizumab. Other pharmaceuticals targeting inflammation are also in the line-up for testing.