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Roche arthritis drug reduces loss of life in hospitalized sufferers with extreme Covid, Oxford researchers say

A pharmacist shows a box of tocilizumab, which is used to treat rheumatoid arthritis, in the pharmacy of Cambrai Hospital in France on April 28, 2020.

Pascal Rossignol | Reuters

A drug used to treat people with rheumatoid arthritis appears to reduce the risk of death in hospitalized patients with severe Covid-19, especially when combined with the steroid dexamethasone, Oxford University researchers said Thursday.

Oxford researchers found that the drug tocilizumab, an intravenous drug of A department of the Swiss drug manufacturer Roche also shortened the length of stay for patients in hospitals and reduced the need for a ventilator. The study was part of the recovery study, which has tested a number of potential treatments for Covid-19 since March.

“Previous studies of tocilizumab had shown mixed results and it was unclear which patients might benefit from the treatment,” said Peter Horby, professor at Oxford University and co-investigator for the recovery study, in a statement. “We now know that tocilizumab benefits apply to all COVID patients with low oxygen levels and significant inflammation.”

A total of 2,022 patients were randomly selected to receive tocilizumab, sold under the brand name Actemra, by intravenous infusion and compared to 2,094 patients who were randomly selected to receive standard care alone. The researchers said 82% of patients were also taking a steroid like dexamethasone, another drug that was found to reduce deaths in the sickest Covid-19 patients.

Researchers said 596 patients in the tocilizumab group died within 28 days, compared with 694 patients in the standard care group. That means that for every 25 patients treated with tocilizumab, “an extra life would be saved,” said Oxford researchers.

The drug increased the chances of being discharged from 47% to 54% within 28 days, the researchers said. The benefits have been seen in all patients, including those who need mechanical ventilators in an intensive care unit, they added. In patients who were not given a ventilator prior to the start of the study, tocilizumab reduced the chance of getting invasive mechanical ventilation or death from 38% to 33%, the researchers said.

The researchers said that using tocilizumab in combination with dexamethasone reduced mortality by about a third in patients who require oxygen and by almost half in patients who require a ventilator.

The results of the Oxford study have not yet been published in a peer-reviewed journal.

Public health officials and infectious disease experts say world leaders will need a range of drugs and vaccines to end the pandemic that, according to Johns, will infect more than 107.4 million people in just over a year and has killed at least 2.3 million people at Hopkins University.

In the US, the Food and Drug Administration has approved Gilead Sciences’ antiviral drug Remdesivir for the treatment of Covid-19 patients who are 12 years or older and require hospitalization.

The FDA has approved the use of two monoclonal antibody treatments as well as two vaccines – from Pfizer and Moderna. A third vaccine from Johnson & Johnson is expected to receive FDA approval as early as this month.

The Covid-19 Therapy Randomized Evaluation, or Recovery Study, was launched in March by researchers at Oxford University to find treatments for Covid-19. The study previously showed that hydroxychloroquine, lopinavir ritonavir, azithromycin, and convalescent plasma had no benefits for patients hospitalized with Covid-19.

The study is currently investigating aspirin, the anti-inflammatory drugs baricitinib and colchicine, and Regeneron’s antibody cocktail.

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Chugai soars after UK says drug reduces hospital time for Covid sufferers

The Chugai Pharmaceutical Co. company logo will be displayed on Monday, August 18, 2014 at the headquarters of Chugai Pharma Manufacturing Co. in Tokyo, Japan.

Kiyoshi Ota | Bloomberg via Getty Images

SINGAPORE – Shares in Japanese drug maker Chugai Pharmaceutical rose sharply in trading Tuesday after the UK government found the drug tocilizumab was effective in reducing the risk of death and hospital stay for Covid patients.

In trading on Tuesday morning, Chugai’s shares rose 16.26%. The stock has since trimmed some of those gains, but is still trading 7% higher. Tuesday was the first trading day of the week for Chugai shares as Japanese markets were closed on Monday for a holiday.

In a press release on Thursday, the UK said the results of a government-funded clinical trial showed that tocilizumab was among two drugs that “reduced the relative risk of death by 24% when given to patients within 24 hours of entering the intensive care unit was administered “.

The press release also states that patients who received the drugs typically used to treat rheumatoid arthritis “left the intensive care unit an average of 7 to 10 days earlier”.

UK Health and Welfare Secretary Matt Hancock said the results were “another milestone in finding a way out of this pandemic”.

The government also said it will start promoting tocilizumab use in patients admitted to the intensive care unit. NHS will also be working with manufacturer Roche to ensure treatment remains available to UK patients.

Tocilizumab, marketed as Actemra or RoActemra, is part of a joint development between Roche and Chugai. Roche is also the majority shareholder in Chugai.

Last week, Prime Minister Boris Johnson put England on hold to contain a variant of Covid-19 that is more contagious than previous strains.

Coronavirus infection rates continue to rise in many parts of the world even as countries start introducing vaccinations. As a result, some governments have reintroduced social distancing restrictions.

To date, the disease has infected at least 90.8 million people and killed more than 1.9 million people worldwide, according to Johns Hopkins University.

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Research Says Blood Plasma Reduces Threat of Extreme Covid-19 if Given Early

It will be difficult “to find and diagnose them in this vanishingly small window,” said Dr. Ilan Schwartz, an infectious disease doctor at the University of Alberta who was not involved in the study. “The study looks solid, but it isn’t exactly practical in the real world.”

Plasma has additional logistical hurdles, said Dr. Titanji from Emory University. Treatment is given as an intravenous infusion – a process that requires skilled hands – and patients must be monitored afterward. That might be easier in long-term care facilities, but far more difficult for the general population, she said.

And plasma may not work as well as monoclonal antibody therapy – a synthetic preparation that is made en masse in the laboratory and not drawn from human blood, and that focuses on only one or two types of antibody at a time, rather than the total amount produced naturally by the immune system. Two types of monoclonal antibody treatments have been approved for emergencies in Covid patients.

But plasma has some advantages over monoclonal antibody treatments, emphasized Dr. Polack.

Because monoclonal antibodies are synthetic and tedious to make, they come at a high price, sometimes costing thousands of dollars (although the US government has prepaid some doses). The limited supply chain of treatment, as well as unexpectedly low demand, have made it inaccessible to many patients in need in the US and abroad.

In countries like Argentina, plasma could be one of the best treatment options available, said Dr. Polack. Plasma infusions in Buenos Aires cost less than $ 200 per patient. “It’s more accessible, cheaper, more universal,” he said.

Even in the United States, plasma “really is the only game in town that is widely available in terms of antibody therapy,” said Dr. Wang from Stanford.

Instead of viewing monoclonal antibodies as an upgrade for convalescent plasma, “they each have a different place in the armory,” said Dr. Pirofski. “Anything this virus can control is really an incredible benefit at this point.”