January 14, 2021

Arthritis drugs could save the lives of critically ill COVID-19 patients

Using existing drugs in different, unintended therapy areas is no new proposition. Exploring other uses of medicines can result in the bypass of significant obstacles that exist in the traditional roadmap of a drug’s development. Reduced research time and lesser extent of clinical trials brings the costs of these treatments down. Furthermore, repurposed drugs can reveal new targets and pathways to be explored and provide options for those with rare diseases that simply would not have existed otherwise.2

Now it seems that repurposed drugs are on the horizon to help patients suffering from COVID-19. Research has found that two previously developed drugs could save the lives of one in every 12 intensive care patients suffering from severe COVID-19 – reducing a patients risk of death by up to 24%.3

In light of this news, the NHS began using one of the drugs, tocilizumab to treat these patients last Friday.

But that is not the only good news, another drug named sarilumab is thought to do the same, with one added benefit. Sarilumab also appears to be reducing the time patients spend in the intensive care unit by about 7-10 days, compared to others receiving standard treatment.3

These results come from a clinical trial named Remap-Cap (Randomized Embedded Multifactorial Adaptive Platform for Community-Acquired Pneumonia) involving over 3,900 COVID-19 from 15 different countries around the world.4

So why were these drugs trialled in the first place and what drug family do they belong to?

For a while now, we have known that COVID-19 is linked to critical inflammation levels in the body. These medicines suppress the effect of proteins that result in an overreaction of the immune system, causing severe inflammation.5 This trait let to the hypothesis that these medicines may be beneficial in the treatment of COVID-19. The drugs, sarilumab and tocilizumab belong to a drug family called the IL-6 receptor antagonists and are usually used to treat rheumatoid arthritis.

However, these is one downside to the use of these drugs in treatment, they are far more expensive (£750-£1000) than the typical drug used to treat COVID-19 in ICU (dexamethasone, £5).6 Because of this, the use of this medicines is reserved for the use of critically ill patients only.

Though the findings of this study are still to undergo peer review, the preliminary results appear to be incredibly promising. Yet despite this news and that of new vaccine approvals, we all must continue to play our part to relieve pressure on NHS staff and hospital space. The show must go on – we cannot afford to let our guard down yet.

Disclaimer: These medicines (tocilizumab and sarilumab) have not yet been approved by the MHRA. They have been tested in clinical trials but have not yet been peer reviewed. The government is only advising the use of these medicines in patients that are critically ill in ICU to prevent death.

References:

  1. Picture of woman being temperature tested https://unsplash.com/photos/yqLsYiuQgwo
  2. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjWiKb2yJvuAhWxC2MBHb4vC0AQFjABegQIBBAC&url=https%3A%2F%2Fwww.mdpi.com%2F1999-4915%2F12%2F9%2F1058%2Fpdf&usg=AOvVaw22to7usIytLnP1pvb8viTE
  3. https://www.theguardian.com/world/2021/jan/07/covid-arthritis-drugs-could-help-save-lives-of-seriously-ill–patients-research-finds
  4. https://www.remapcap.org/
  5. https://theconversation.com/inflammation-the-key-factor-that-explains-vulnerability-to-severe-covid-144768
  6. https://www.ft.com/content/8e9acd3c-a151-4129-a7da-9c643c586301

 

THE TALKING MEDICINES BLOG