Critical Covid patients on arthritis drug ‘less likely to die’

Arthritis drug improves outcomes for critically ill Covid-19 patients, study finds

Critically ill patients with Covid-19 are less likely to die and will spend less time in intensive care when treated with an arthritis drug that reduces inflammation by modifying the immune system, according to international research partially funded by the Health Research Board (HRB).

The early findings, which are yet to be published, are from the Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP) trial.

Led by Imperial College London and the Intensive Care National Audit and Research Centre (ICNARC) in the United Kingdom (UK) and Utrecht University in the Netherlands, the trial evaluated the effect of treatments on a combination of survival and length of time patients need support in an intensive care unit (ICU).

Provisional results showed that treatment with tocilizumab, an immunosuppressive drug used to treat rheumatoid arthritis, reached a key efficacy endpoint among critically ill patients with severe Covid-19, compared to patients who did not receive any immune modulation treatment.

Researchers said they released the findings before they have been peer-reviewed because of the clinical implications for patients.

Prof Alistair Nichol, Chair of Critical Care Medicine at University College Dublin and Consultant in Intensive Care Medicine at St Vincent’s University Hospital also in the capital city, who leads the Irish arm of the trial, said: “These early findings show that a single course of treatment with this immune modulating drug can significantly improve the outcomes for the most critically ill Covid-19 patients in intensive care. Once we have completed the analysis of the full dataset, we hope these findings will allow critical care teams around the world to improve the outcomes of the sickest Covid-19 patients.”

REMAP-CAP began investigating Covid-19 treatments in March 2020, enrolling hospitalised patients with either moderate or severe (requiring ICU care) symptoms of the disease.

More than 2,000 patients in 15 countries have been enrolled at more than 260 hospitals worldwide and randomised to multiple treatment combinations.

Welcoming the findings, Dr Mairéad O’Driscoll, Chief Executive, HRB said: “Research is combating Covid-19 from all angles. We have news this week of two potential vaccines which we hope will prevent us getting the disease, but we are also understanding better how to treat Covid-19 as well, which improves Covid-19 patient outcomes and helps reduce pressure on critical care services.”

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