Critically ill Covid-19 patients to receive new potentially life-saving drugs

NHS patients will have access to tocilizumab and sarilumab – which are typically used to treat rheumatoid arthritis – under updated guidance due to be issued tomorrow by the Government and the NHS to Trusts across the UK.

It comes after results from the Government-funded REMAP-CAP clinical trial showed that both drugs reduced the risk of mortality by 8.5% when administered to patients within a day of entering intensive care alongside a corticosteroid, such as dexamethasone.

Professor Anthony Gordon, chair in anaesthesia and critical care at Imperial College London and a consultant in intensive care medicine at Imperial College Healthcare NHS Trust, 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.”

The findings, which been submitted to a peer-reviewed journal, are based on an analysis of 803 patients from six countries, 353 of whom had been assigned to tocilizumab and 48 to sarilumab.

The majority of patients were also treated with corticosteroids and were receiving respiratory support.

Hospital mortality was 27.3% among patients receiving tocilizumab or sarilumab, compared with 35.8% of patients in the control group who did not receive the drugs, the researchers said.

Treatment with tocilizumab or sarilumab is thought to cost somewhere between £750 and £1,000 and is administered intravenously either as a one or two dose regime.

Professor Gordon added: “For every 12 patients in intensive care you treat with these drugs, based on the evidence we saw, you would expect to save one life.”

Health 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.”

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.”

Tocilizumab and sarilumab have been added to the Government’s export restriction list, the Department of Health and Social Care (DHSC) said.

This will protect supply for UK patients by enforcing regulatory action on those who flout the restrictions, it added.

Commenting on the findings, Peter Horby, professor of Emerging Infectious Diseases, the University of Oxford’s Centre for Tropical Medicine and Global Health, said: “It is great to see a positive result at a time that we really need good news and more tools to fight Covid.

“This is a great achievement for REMAP-CAP – it demonstrates the power of adaptive platform trials.

“Importantly, the findings of a benefit are in addition to corticosteroids, which were taken by 93% of the participants.

“This means we now have two drugs, which combined have a greater effect.”