Saturday, August 8, 2020
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Arthritis anti-inflammatory treatment could halt immune system ‘storm’ to coronavirus

Doctors say anti-inflammatory treatment tocilizumab could save lives by halting the immune system ‘storm’ that has killed thousands of virus patients (file photo)
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Could an arthritis drug be a breakthrough treatment for Covid? Doctors say anti-inflammatory treatment could halt the immune system ‘storm’ responsible for killing thousands

  • Doctors say anti-inflammatory treatment tocilizumab could save lives
  • It could be used to halt the immune system ‘storm’ that has killed thousands
  • If successful, it would only be second drug proven to save lives from the virus 

Hopes are rising that a breakthrough coronavirus drug will save lives by halting the immune system ‘storm’ that has killed thousands of people.

Results of a major trial of anti-inflammatory treatment tocilizumab are expected to be published this week.

Doctors are confident the drug, which was originally developed as a treatment for rheumatoid arthritis, will stop the hyperinflammatory storm that happens when the immune system starts attacking the body.

If this process can be halted it could dramatically reduce coronavirus deaths, many of which are caused by this aggressive immune response rather than the virus itself.

If successful it would be only the second drug to be proven to save lives from coronavirus – so far the only treatment shown to work is steroid dexamethasone.

Doctors say anti-inflammatory treatment tocilizumab could save lives by halting the immune system ‘storm’ that has killed thousands of virus patients (file photo)

Researchers believe a wide variety of Covid treatments are needed to make the biggest difference, allowing doctors to target drugs against specific problems.

The trial – which has involved 450 Covid-19 patients in 60 hospitals around the world – was completed and the results sealed on July 22, according to investigators.

Swiss drugs giant Roche – which makes the treatment – is expected to announce the findings to the stock market in the coming days.

Doctors have not yet seen the results but are hopeful of a positive outcome.

Dr Taryn Youngstein, an inflammation specialist at Imperial College London who worked on the trial, said: ‘The data gets cleaned up and then they’ll have to read out, which usually takes about a week.

‘It’s very clear that the major form of Covid that kills people is related to the host response – the body’s response to the virus – rather than the virus itself.

‘We need to think about how we can suppress this response and the way we do that is to use cytokine inhibition.’

Tocilizumab has been used for years to dampen the immune response in rheumatoid arthritis.

But it has come into its own more recently for cancer patients undergoing risky but extremely effective CAR-T therapy.

These patients often suffer a cytokine storm as a side effect of CAR-T, and tocilizumab has been effective at minimising the danger when this happens.

Dr Youngstein added: ‘We are very familiar with the drug – we use it all the time.

‘We know it’s very safe and very well tolerated.

The treatment could dramatically reduce coronavirus deaths – many of which are caused by the aggressive immune response rather than the virus itself (file photo)

The treatment could dramatically reduce coronavirus deaths – many of which are caused by the aggressive immune response rather than the virus itself (file photo) 

‘The question is whether it work in Covid-19. But I don’t see a reason why it wouldn’t, because it works in these other situations.’

Hopes that tocilizumab will work was boosted by an Italian study, published last month, which suggested it might slash deaths by 39 per cent.

But that study was a retrospective analysis of patients who had already been treated. Patients were not randomly assigned to receive the drug and there was no placebo arm, so the results were inconclusive.

The new study will address these issues – it is a gold standard randomised control trial, with patients given the drug at different stages of their disease progression to see who is most likely to benefit.

Dr Youngstein added: ‘The crucial thing is how we identify the type of patient that could respond to this treatment.

‘Because it won’t be everyone.’

Dr Nichola Cooper of Imperial’s department of immunology and inflammation, who also worked on the trial, believes there is a ‘window of opportunity’ in which tocilizumab will have the greatest effect.

She said: ‘When patients require oxygen but they’re not yet needing intensive care – actually preventing that progression and stopping people going onto ventilation – feels like the right time to treat.

‘But we need to see if the study shows that is correct.’ 



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