Tocilizumab
A rheumatoid arthritis drug called tocilizumab, which is being used for the treatment of severe COVID19 patients, has fallen short as an effective treatment. Once it has been considered a promising cure for hospitalized patients with coronavirus by the experts. However, now three consecutive trials have proved that it is unable to increase the rate of survival among the patients. Although a fourth study has found it to be effective in increasing the chances of survival the findings of the study are less reliable as it is an observational study. The results of these reports have left the doctors confused about the usage of tocilizumab in the treatment of COVID19. Initial three studies have been published in the journal of the American Medical Association. The fourth one has been released in the New England Journal of Medicine.
Experts have said that the drug cannot be taken as a magic bullet, which should be used for all the patients with severe COVID19 infection. However, there is room for the use of this drug for a specific group of patients. Health officials have said that upcoming studies on the drug might help in identifying the patients who might benefit from it. Tocilizumab is being sold under the brand name of Acetmra. The medicine treats rheumatoid arthritis by blocking interleukin -6. It is a molecule, which causes inflammation. In the first wave of the pandemic, it has been used extensively in the US after the news has started floating from China and Europe that the drug is quite helpful in treating seriously ill people with COVID19. Nevertheless, these reports have been based on observational studies only. Scientists have examined only existing data without designing a trial to identify the efficacy of the drug.
The first one out of three studies has found that COVID19 patients in Italy, who have not been admitted to the intensive care and treated with tocilizumab, have not done any better than those who have received standard care. Another study in France has revealed that tocilizumab has shown a minor improvement by the 14th day as compared to standard care; however, there has been no difference in the rate of survival between both groups of patients by the 28th day. Although the third study has found that, the risk of in-hospital death has been 30 percent less among the patients who have received the drug as part of the treatment as compared to those who have not been given this drug. However, again it has been an observational trial. The fourth study has been done on 243 COVID19 patients from Seven Boston area hospitals. All the participants of this study have been hospitalized at the peak of the surge in the area. The lead author of the study Dr. John H Stone has said that the findings of the study do not support the use of tocilizumab in moderately ill patients. He has claimed that the rate of intubation or death has been in both groups of patients who have been treated with tocilizumab and those who have not been treated with the medicine.
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