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Arthritis drugs effective in improving survival in sickest COVID-19 patients

Published: 07 January 2021

Patients across the UK who are admitted to intensive care units due to COVID-19 are set to receive a treatment that can reduce the time spent in hospital by up to 10 days, an international study supported by the NIHR has found.

Results from the REMAP-CAP clinical trial evaluated the effect of treatments on a combination of survival and length of time patients need support in an intensive care unit (ICU). Patients receiving tocilizumab and a second drug called sarilumab - both types of immune modulators - have a significant impact on patient survival and can reduce the relative risk of death by 24% when administered to patients within 24 hours of entering intensive care.

The rollout of these treatments could therefore contribute significantly towards reducing pressures on hospitals over the coming weeks and months.

The latest findings on tocilizumab, an immunosuppressive drug used to treat rheumatoid arthritis, add to REMAP-CAP findings from November last year, which found that tocilizumab significantly improves outcomes for critically ill patients with severe COVID-19.
Due to the clinical implications for patients, the researchers have released the findings before they have been peer reviewed, but are working to analyse and publish them as soon as possible.

Updated guidance will be issued tomorrow by the government and the NHS to Trusts across the UK, encouraging them to use tocilizumab in their treatment of COVID-19 patients who are admitted to intensive care units, effective immediately.

The REMAP-CAP study, based in 15 countries across Europe, involves more than 3,900 COVID-19 patients. The study is led by Imperial College London and the Intensive Care National Audit & Research Centre (ICNARC) in the UK and Utrecht University in Europe. As of November 2020 75% of all study participants had been recruited in the UK through the NIHR’s Clinical Research Network (CRN).

Professor Anthony Gordon, Chair in Anaesthesia and Critical Care at Imperial College London, a Consultant in Intensive Care Medicine at Imperial College Healthcare NHS Trust and NIHR Research Professor said:

“This is a significant finding which could have immediate implications for the sickest patients with COVID-19. We found that among critically ill adult patients – those receiving breathing support in intensive care – treatment with these drugs can improve their chances of survival and recovery.

“At a time when hospitalisations and deaths from COVID-19 are soaring in the UK, it’s crucial we continue to identify effective treatments which can help to turn the tide against this disease.”

Health and Social Care Secretary Matt Hancock said:

“The UK has proven time and time again it is at the very forefront of identifying and providing the most promising, innovative treatments for its patients.

“Today’s results are yet another landmark development in finding a way out of this pandemic and, when added to the armoury of vaccines and treatments already being rolled out, will play a significant role in defeating this virus.

“We have worked quickly to ensure this treatment is available to NHS patients without delay, meaning hundreds of lives will be saved. I am hugely proud of the significant role our NHS and its patients have played in this international trial, and grateful to the outstanding scientists and clinicians behind REMAP-CAP who have brought this treatment to our patients.”

Deputy Chief Medical Officer Professor Jonathan Van-Tam said:

“This is a significant step forward for increasing survival of patients in intensive care with COVID-19. The data shows that tocilizumab, and likely sarilumab, speed up and improve the odds of recovery in intensive care, which is crucial for helping to relieve pressure on intensive care and hospitals and saving lives.

“This is evidence of the UK’s excellent research infrastructure and life sciences industry advancing global understanding of this disease, which we have done both through our own programme of clinical research and through our ability to make very large contributions to international studies.”

More information on the study is available on the REMAP-CAP website.

The study is also featured in a case study..

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