Roche, Sanofi arthritis drugs reduce death rates among sickest COVID-19 patients

Treating critically ill COVID-19 patients with Roche's Actemra or Sanofi's Kevzara arthritis drugs significantly improves survival rates and reduces the amount of time patients need intensive care, study results showed on Thursday.

The findings, which have not yet been peer-reviewed, showed that the immunosuppressive drugs - Actemra, also known as tocilizumab, and Kevzara, also known as sarilumab - reduced death rates by 8.5 percentage points among patients hospitalised and severely ill with the pandemic disease.

That would mean that for every 12 patients treated with one of the two drugs, an extra life would be saved, said Anthony Gordon, an Imperial College London professor of anaesthesia and critical care who co-led the study. The data will boost confidence that some existing drugs can be repurposed to help with the pandemic that has killed more than 1.87 million people and crushed global economies.

It also comes as countries struggle to contain two variants of the virus found in South Africa and Britain that are more transmissible and have driven a surge in infections.

The UK government said it would ask doctors treating critically ill COVID-19 patients in hospital intensive care units to begin using the drugs immediately.

"This is a significant step forward for increasing survival of patients," the UK's deputy chief medical officer, Jonathan Van-Tam, said in a statement.

He said the drugs would be "crucial for helping to relieve pressure on intensive care and hospitals and saving lives".

Drug companies have been scouring their existing portfolios for possible therapies. So far the generic steroid dexamethasone and Gilead's antiviral drug remdesivir have been approved for treating patients with severe symptoms.

The United States has also authorised emergency use of some antibody drugs for non-hospitalised COVID-19 patients.

The data, from around 800 severely ill COVID-19 patients involved in an international study known as the REMAP-CAP trial showed that the two drugs reduced mortality rates from 35.8 percent in a control group to 27.3 percent among patients receiving either tocilizumab or sarilumab.

"That's a big change in survival," said Gordon. "They are both lifesaving drugs."

The results also showed that on average, patients treated with Actemra or Kevzara recovered more swiftly and were able to be discharged from intensive care units around seven to 10 days earlier than those who did not get these drugs.

"This ... could have immediate implications for the sickest patients with COVID-19," Gordon said. "We're seeing the actual benefit in terms of survival and quicker recovery."

Until now, results for Actemra and Kevzara - both a type of drug known as IL-6 receptor antagonists - in treatment trials in patients with COVID-19 have been mixed.

Sanofi said in September that Kevzara - which it produces with partner Regeneron - failed to meet the main goals of a US study testing it in critically ill COVID-19 patients.

In November, Roche said research showed Actemra helped the sickest COVID-19 patients, but it was unclear if it kept people alive or shortened how long they needed intensive care support such as mechanical ventilation, or both.

Gordon noted on Thursday that previous studies had found no clear benefit, but said those trials had included less severely ill patients and started treatment at different stages in the disease course.

"A crucial difference may be that in our study, critically ill patients were enrolled within 24 hours of starting organ support," he said. "This highlights a potential early window for treatment where the sickest patients may gain the most benefit from immune modulation treatment."

Thursday's trial data have not yet been peer-reviewed but were published online on the medRxiv website.