{"id":19121,"date":"2021-01-16T14:32:10","date_gmt":"2021-01-16T14:32:10","guid":{"rendered":"http:\/\/evaggelatos.com\/?p=19121"},"modified":"2021-01-16T16:55:07","modified_gmt":"2021-01-16T16:55:07","slug":"2-arthritis-drugs-reduce-deaths-in-very-ill-covid-patients-study-finds","status":"publish","type":"post","link":"https:\/\/evaggelatos.com\/?p=19121","title":{"rendered":"2 Arthritis Drugs Reduce Deaths in Very Ill Covid Patients of ICU, Study Finds"},"content":{"rendered":"<p id=\"article-summary\" class=\"css-w6ymp8 e1wiw3jv0\">The big dip in mortality shown in the trial of about 800 patients has caught some experts by surprise because previous studies of the drugs showed little benefit.<\/p>\n<div class=\"css-1aweabf\">\n<div class=\"css-1oommtz\"><\/div>\n<\/div>\n<div class=\"css-dakego ehw59r12\" data-testid=\"photoviewer-children\">\n<div class=\"css-tux0zj ehw59r13\" data-testid=\"photoviewer-overlay\">\n<div class=\"css-1ammj21 ehw59r11\" data-testid=\"photoviewer-captionblock\"><\/div>\n<div class=\"css-h7jfto ehw59r14\">\n<div>\n<div class=\"css-8h527k\">\n<div data-testid=\"lazyimage-container\"><picture class=\"css-1j5kxti\"><source srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=600\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 3),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 3),(max-width: 599px) and (min-resolution: 3dppx),(max-width: 599px) and (min-resolution: 288dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1200\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 2),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 2),(max-width: 599px) and (min-resolution: 2dppx),(max-width: 599px) and (min-resolution: 192dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1800\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 1),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 1),(max-width: 599px) and (min-resolution: 1dppx),(max-width: 599px) and (min-resolution: 96dpi)\" \/><img decoding=\"async\" src=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-articleLarge.jpg?quality=75&amp;auto=webp&amp;disable=upscale\" sizes=\"((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 60vw, 100vw\" srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-articleLarge.jpg?quality=90&amp;auto=webp 600w,https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-jumbo.jpg?quality=90&amp;auto=webp 1024w,https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-superJumbo.jpg?quality=90&amp;auto=webp 2048w\" alt=\"\" \/><\/picture><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div>\n<header class=\"css-z40kjo euiyums1\">\n<div class=\"css-79elbk\" data-testid=\"photoviewer-wrapper\">\n<div class=\"css-1a48zt4 ehw59r15\" data-testid=\"photoviewer-children\">\n<figure class=\"sizeMedium layoutHorizontal css-1ox9jel\" role=\"group\" aria-label=\"media\">\n<div class=\"css-bsn42l\"><picture><source srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=600\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 3),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 3),(max-width: 599px) and (min-resolution: 3dppx),(max-width: 599px) and (min-resolution: 288dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1200\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 2),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 2),(max-width: 599px) and (min-resolution: 2dppx),(max-width: 599px) and (min-resolution: 192dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1800\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 1),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 1),(max-width: 599px) and (min-resolution: 1dppx),(max-width: 599px) and (min-resolution: 96dpi)\" \/><img decoding=\"async\" class=\"css-11cwn6f\" src=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-articleLarge.jpg?quality=75&amp;auto=webp&amp;disable=upscale\" sizes=\"((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 60vw, 100vw\" srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-articleLarge.jpg?quality=90&amp;auto=webp 600w,https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-jumbo.jpg?quality=90&amp;auto=webp 1024w,https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG1\/merlin_181954782_0c424537-62c5-4613-bfcf-44de1ac14c15-superJumbo.jpg?quality=90&amp;auto=webp 2048w\" alt=\"A Covid patient at Providence Cedars-Sinai Tarzana Medical Center in California, last week. New research findings \u2014 still awaiting formal review for publication \u2014 are compelling enough to prompt a shift in guidance in Britain.\" \/><\/picture><\/div><figcaption class=\"css-17ai7jg e18f7pbr0\"><span class=\"css-16f3y1r e13ogyst0\" aria-hidden=\"true\">A Covid patient at Providence Cedars-Sinai Tarzana Medical Center in California, last week. New research findings \u2014 still awaiting formal review for publication \u2014 are compelling enough to prompt a shift in guidance in Britain.<\/span><span class=\"css-cnj6d5 e1z0qqy90\"><span class=\"css-1ly73wi e1tej78p0\">Credit&#8230;<\/span>Apu Gomes\/Agence France-Presse \u2014 Getty Images<\/span><\/figcaption><\/figure>\n<\/div>\n<\/div>\n<div class=\"css-18e8msd\">\n<div class=\"css-vp77d3 epjyd6m0\">\n<div class=\"css-hus3qt ey68jwv0\" aria-hidden=\"true\"><a class=\"css-uwwqev\" href=\"https:\/\/www.nytimes.com\/by\/katherine-j--wu\"><img decoding=\"async\" class=\"css-1rjmmt7 ey68jwv2\" title=\"Katherine J. Wu\" src=\"https:\/\/static01.nyt.com\/images\/2020\/08\/11\/reader-center\/author-katherine-j-wu\/author-katherine-j-wu-thumbLarge.png\" alt=\"Katherine J. Wu\" \/><\/a><\/div>\n<div class=\"css-1baulvz\">\n<p class=\"css-4z5zii e1jsehar1\"><span class=\"byline-prefix\">By <\/span><a class=\"css-brehiz e1jsehar0\" href=\"https:\/\/www.nytimes.com\/by\/katherine-j--wu\"><span class=\"css-1baulvz last-byline\">Katherine J. Wu<\/span><\/a><\/p>\n<\/div>\n<\/div>\n<ul class=\"css-1u1psjv epjyd6m3\">\n<li class=\"css-ccw2r3 epjyd6m1\"><time class=\"css-ld3wwf e16638kd2\" datetime=\"2021-01-13T15:53:21-05:00\"><span class=\"css-1sbuyqj e16638kd3\">Published Jan. 8, 2021<\/span><span class=\"css-233int e16638kd4\">Updated Jan. 13, 2021<\/span><\/time><\/li>\n<\/ul>\n<\/div>\n<\/header>\n<\/div>\n<section class=\"meteredContent css-1r7ky0e\">\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-axufdj evys1bk0\">The British government on Friday <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.cas.mhra.gov.uk\/ViewandAcknowledgment\/ViewAlert.aspx?AlertID=103134\" target=\"_blank\" rel=\"noopener noreferrer\">issued new guidance<\/a> encouraging health care providers to use two arthritis drugs to treat severely sick Covid-19 patients, following the release of promising data from a clinical trial that has not yet undergone formal scientific review.<\/p>\n<p class=\"css-axufdj evys1bk0\">The <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2021.01.07.21249390v1\" target=\"_blank\" rel=\"noopener noreferrer\">findings<\/a> in a new paper show that treatment regimens involving the drugs tocilizumab or sarilumab reduced the death rate among Covid patients in intensive care to about 27 percent, compared with 36 percent among patients who did not receive the drugs. Based on these results, about one death would be prevented for every 12 I.C.U. patients treated early with these drugs. All of the patients in the trial received the drugs within 24 hours of entering intensive care.<\/p>\n<p class=\"css-axufdj evys1bk0\">\u201cI think it\u2019s a huge result,\u201d said Dr. Anthony Gordon, an anesthesiologist and critical care physician at Imperial College London and the trial\u2019s lead researcher. \u201cShowing that drugs that are available and can be used to save lives, in this pandemic, is a wonderful achievement.\u201d<\/p>\n<p class=\"css-axufdj evys1bk0\">The results raise the profile of these drugs as among the few so far, apart from steroids like dexamethasone, that have reduced Covid deaths in a well-designed clinical trial. (Most of the new study\u2019s participants also took steroids during their hospital stay.)<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"><\/aside>\n<\/div>\n<div class=\"css-8atqhb\"><\/div>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-axufdj evys1bk0\">The big dip in mortality shown in the trial of about 800 patients caught some experts by surprise. Other studies testing the effects of tocilizumab and sarilumab have ended in disappointment, showing little to no benefit in people hospitalized for Covid.<\/p>\n<p class=\"css-axufdj evys1bk0\">Against the backdrop of other trials, some of which were more rigorously designed than this one, \u201cI guess I would interpret with caution until this was published in a peer-reviewed journal,\u201d said Dr. Lauren Henderson, a rheumatologist at Boston Children\u2019s Hospital who wasn\u2019t involved in the study.<\/p>\n<p class=\"css-axufdj evys1bk0\">Because all treatment trials are run with their own quirks and patient populations, \u201cit\u2019s difficult to compare across different studies,\u201d added Dr. Emma Kaplan-Lewis, an infectious disease physician with the New York City Health and Hospitals Corporation. She has <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2030340\" target=\"_blank\" rel=\"noopener noreferrer\">helped to conduct trials on tocilizumab<\/a>, including one that didn\u2019t show an improvement in patient survival, but wasn\u2019t involved in the new study.<\/p>\n<p class=\"css-axufdj evys1bk0\"><strong>\u201cMy general impression is that tocilizumab and sarilumab do work for some patients,\u201d she said. \u201cBut there is a sweet spot \u2014 it\u2019s not for everybody, at all times.\u201d<\/strong><\/p>\n<p class=\"css-axufdj evys1bk0\">While many treatments for Covid target the coronavirus itself, tocilizumab and sarilumab work to quiet the immune system which, when triggered by an infection, can overreact and start to destroy the body\u2019s own tissues. This immunological friendly fire is thought to fan the flames of many of the most serious Covid cases.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\">\n<div id=\"c-col-editors-picks\" class=\"css-j64t31\">\n<article class=\"css-5raq8g\">\n<div class=\"css-1rcvpgy\"><\/div>\n<\/article>\n<\/div>\n<\/aside>\n<\/div>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-axufdj evys1bk0\">Given to seriously sick patients, these drugs can act like molecular mufflers, quieting the signals, or cytokines, sent and received by immune cells and keeping inflammation in check. Tocilizumab and sarilumab specifically block the signaling of a cytokine called IL-6, and are common arthritis treatments.<\/p>\n<p class=\"css-axufdj evys1bk0\">But against Covid-19, the drugs have produced <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2030340\" target=\"_blank\" rel=\"noopener noreferrer\">mixed<\/a> or <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/2772186\" target=\"_blank\" rel=\"noopener noreferrer\">lackluster<\/a> results. <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/2772187\" target=\"_blank\" rel=\"noopener noreferrer\">Researchers<\/a> <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2020.08.27.20183442v2\" target=\"_blank\" rel=\"noopener noreferrer\">testing tocilizumab<\/a> in hospitalized patients found that while it seemed to <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32359035\/\" target=\"_blank\" rel=\"noopener noreferrer\">slow the sicknesses<\/a> of some people, it <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2028836\" target=\"_blank\" rel=\"noopener noreferrer\">did little to curb death rates<\/a>. <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.sanofi.com\/en\/media-room\/press-releases\/2020\/2020-07-02-22-30-00\" target=\"_blank\" rel=\"noopener noreferrer\">Clinical trials<\/a> run by companies like <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.sanofi.com\/en\/media-room\/press-releases\/2020\/2020-09-01-07-00-00\" target=\"_blank\" rel=\"noopener noreferrer\">Regeneron and Sanofi<\/a> testing the drugs were ultimately halted when their benefits didn\u2019t pan out as expected. Another trial, run by <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.roche.com\/investors\/updates\/inv-update-2020-07-29.htm\" target=\"_blank\" rel=\"noopener noreferrer\">Roche<\/a>, failed to meet its goals last summer. Disappointed by the treatments\u2019 spotty performance, many experts <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/2772184\" target=\"_blank\" rel=\"noopener noreferrer\">lost interest in deploying them in clinical settings<\/a>, and the National Institutes of Health issued guidelines <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.covid19treatmentguidelines.nih.gov\/immune-based-therapy\/immunomodulators\/interleukin-6-inhibitors\/\" target=\"_blank\" rel=\"noopener noreferrer\">recommending against their use<\/a>, except in clinical trials.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"><\/aside>\n<\/div>\n<div class=\"css-79elbk\" data-testid=\"photoviewer-wrapper\">\n<div class=\"css-dakego ehw59r12\" data-testid=\"photoviewer-children\">\n<div class=\"css-tux0zj ehw59r13\" data-testid=\"photoviewer-overlay\">\n<div class=\"css-1ammj21 ehw59r11\" data-testid=\"photoviewer-captionblock\"><\/div>\n<div class=\"css-h7jfto ehw59r14\">\n<div>\n<div class=\"css-8h527k\">\n<div class=\"css-1xdhyk6 erfvjey0\"><picture class=\"css-1j5kxti\"><source srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG2\/merlin_171990045_8f80ad22-6dde-4c28-9e33-406560f186a0-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=600\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 3),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 3),(max-width: 599px) and (min-resolution: 3dppx),(max-width: 599px) and (min-resolution: 288dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG2\/merlin_171990045_8f80ad22-6dde-4c28-9e33-406560f186a0-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1200\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 2),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 2),(max-width: 599px) and (min-resolution: 2dppx),(max-width: 599px) and (min-resolution: 192dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG2\/merlin_171990045_8f80ad22-6dde-4c28-9e33-406560f186a0-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1800\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 1),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 1),(max-width: 599px) and (min-resolution: 1dppx),(max-width: 599px) and (min-resolution: 96dpi)\" \/><\/picture><picture><source srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG2\/merlin_171990045_8f80ad22-6dde-4c28-9e33-406560f186a0-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=600\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 3),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 3),(max-width: 599px) and (min-resolution: 3dppx),(max-width: 599px) and (min-resolution: 288dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG2\/merlin_171990045_8f80ad22-6dde-4c28-9e33-406560f186a0-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1200\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 2),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 2),(max-width: 599px) and (min-resolution: 2dppx),(max-width: 599px) and (min-resolution: 192dpi)\" \/><source srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG2\/merlin_171990045_8f80ad22-6dde-4c28-9e33-406560f186a0-mobileMasterAt3x.jpg?quality=75&amp;auto=webp&amp;disable=upscale&amp;width=1800\" media=\"(max-width: 599px) and (min-device-pixel-ratio: 1),(max-width: 599px) and (-webkit-min-device-pixel-ratio: 1),(max-width: 599px) and (min-resolution: 1dppx),(max-width: 599px) and (min-resolution: 96dpi)\" \/><img decoding=\"async\" class=\"css-1m50asq\" src=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG2\/merlin_171990045_8f80ad22-6dde-4c28-9e33-406560f186a0-articleLarge.jpg?quality=75&amp;auto=webp&amp;disable=upscale\" sizes=\"((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 60vw, 100vw\" srcset=\"https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG2\/merlin_171990045_8f80ad22-6dde-4c28-9e33-406560f186a0-articleLarge.jpg?quality=90&amp;auto=webp 600w,https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG2\/merlin_171990045_8f80ad22-6dde-4c28-9e33-406560f186a0-jumbo.jpg?quality=90&amp;auto=webp 1024w,https:\/\/static01.nyt.com\/images\/2021\/01\/08\/science\/08VIRUS-DRUG2\/merlin_171990045_8f80ad22-6dde-4c28-9e33-406560f186a0-superJumbo.jpg?quality=90&amp;auto=webp 2048w\" alt=\"A box of\u00a0tocilizumab in a hospital in Cambrai, France. Officials in Britain have partnered with its manufacturer, Roche, to keep hospitals stocked with the drug.\" \/><\/picture><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<div class=\"css-79elbk\" data-testid=\"photoviewer-wrapper\">\n<div class=\"css-1a48zt4 ehw59r15\" data-testid=\"photoviewer-children\">\n<figure class=\"css-jcw7oy e1g7ppur0\" role=\"group\" aria-label=\"media\"><figcaption class=\"css-1l44abu ewdxa0s0\"><span class=\"css-16f3y1r e13ogyst0\" aria-hidden=\"true\">A box of\u00a0tocilizumab in a hospital in Cambrai, France. Officials in Britain have partnered with its manufacturer, Roche, to keep hospitals stocked with the drug.<\/span><span class=\"css-cnj6d5 e1z0qqy90\"><span class=\"css-1ly73wi e1tej78p0\">Credit&#8230;<\/span>Pascal Rossignol\/Reuters<\/span><\/figcaption><\/figure>\n<\/div>\n<\/div>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-axufdj evys1bk0\">But the findings of the new study add a welcome wrinkle to this pattern of results. When the researchers added tocilizumab or sarilumab to the typical I.C.U. Covid treatment regimen, patients were more likely to survive. The IL-6 blocking drugs also helped Covid patients come off machines and medications necessary to support their heart or lung function, and hastened their departures from the hospital by several days.<\/p>\n<p class=\"css-axufdj evys1bk0\">Because most of the people in the new study were also taking steroids like dexamethasone, the study\u2019s results suggest that tocilizumab and sarilumab can compound the benefits of existing drug regimens, said Dr. Ilan Schwartz, an infectious disease physician at the University of Alberta, who called the findings \u201cimpressive.\u201d<\/p>\n<p class=\"css-axufdj evys1bk0\"><strong>About one-third of the patients in the trial also took the antiviral drug remdesivir, which in October became the first Covid treatment to be approved by the U.S. Food and Drug Administration. Remdesivir on its own, however, doesn\u2019t seem to reduce deaths.<\/strong><\/p>\n<p class=\"css-axufdj evys1bk0\">The new study, which was posted to the preprint server medRxiv on Thursday, has not yet been vetted by experts for publication in a scientific journal. But its findings were compelling enough to prompt a shift in guidance in Britain, where officials have partnered with Roche, the tocilizumab manufacturer, to keep hospitals stocked with the drug.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"><\/aside>\n<\/div>\n<div class=\"css-1fanzo5 StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-axufdj evys1bk0\"><strong>\u201cOrganizations are encouraged to consider prescribing either tocilizumab or sarilumab in the treatment of patients admitted to intensive care with Covid-19 pneumonia,\u201d<\/strong> <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.gov.uk\/government\/news\/nhs-patients-to-receive-life-saving-covid-19-treatments-that-could-cut-hospital-time-by-10-days\" target=\"_blank\" rel=\"noopener noreferrer\">the new guidance from British health authorities<\/a> said. Dr. Gordon noted that this is the strongest <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/www.cas.mhra.gov.uk\/ViewandAcknowledgment\/ViewAlert.aspx?AlertID=103134\" target=\"_blank\" rel=\"noopener noreferrer\">official advice <\/a>issued to date on the pair of immune drugs.<\/p>\n<p class=\"css-axufdj evys1bk0\">Some experts outside of Britain are treading more cautiously. Both Dr. Schwartz and Dr. Kaplan-Lewis noted that although the data might be enough to persuade the F.D.A. to authorize tocilizumab and sarilumab for emergency use in the United States, the jury is still out on these drugs. And Dr. Boghuma Kabisen Titanji, an infectious disease physician at Emory University, pointed out that only about 4 percent\u00a0of the study volunteers identified as Black, which may make the results less applicable to the general population given the heightened vulnerability of communities of color to Covid-19.<\/p>\n<p class=\"css-axufdj evys1bk0\">More studies will be needed to clarify when, and in which patients, tocilizumab and sarilumab work best, and to untangle why their benefits cropped up clearly in some studies, but not others, Dr. Kaplan-Lewis said. It\u2019s also challenging to compare studies coming out now to earlier trials that were conducted when the virus was much less understood, treatments were doled out with less know-how and mortality rates were even higher.<\/p>\n<p class=\"css-axufdj evys1bk0\">\u201cIf patients get better supportive care, maybe their outcomes would be much improved,\u201d said Dr. Krutika Kuppalli, an infectious disease physician at the Medical University of South Carolina who was not involved in the study. \u201cYes, therapeutics are helpful. But it\u2019s also about improving the standard of care for people.\u201d<\/p>\n<p class=\"css-axufdj evys1bk0\">The new study and <a class=\"css-1g7m0tk\" title=\"\" href=\"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/2772185\" target=\"_blank\" rel=\"noopener noreferrer\">others<\/a> have hinted that the drugs\u2019 window of opportunity is narrow \u2014 within the first day or so of admission to an I.C.U., Dr. Kaplan-Lewis said. Given too early, the drugs might not make a measurable dent in the immune response; delivered too late, and the damage may have already been done. \u201cMaybe it\u2019s when a person has just tipped over into being critical,\u201d she said.<\/p>\n<p class=\"css-axufdj evys1bk0\">That inflection point isn\u2019t always easy to define. Patients enter intensive care in different states, and the threshold for critical illness may not be uniform across hospitals. And, like all other immunosuppressive drugs, tocilizumab and sarilumab can raise the risk of infection by other viruses or bacteria.<\/p>\n<p class=\"css-axufdj evys1bk0\">The data is \u201cencouraging,\u201d Dr. Kuppalli said. \u201cBut I think we need to understand why this data looks different from other studies, before we start implementing this as widespread policy.\u201d<\/p>\n<p>Source:https:\/\/www.nytimes.com\/2021\/01\/08\/health\/covid-arthritis-drugs-reduced-deaths.html<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>The big dip in mortality shown in the trial of about 800 patients has caught some experts by surprise because previous studies of the drugs showed little benefit. A Covid patient at Providence Cedars-Sinai Tarzana Medical Center in California, last week. New research findings \u2014 still awaiting formal review for publication \u2014 are compelling enough &hellip; <\/p>\n<p><a class=\"more-link btn\" href=\"https:\/\/evaggelatos.com\/?p=19121\">\u03a3\u03c5\u03bd\u03ad\u03c7\u03b5\u03b9\u03b1 \u03b1\u03bd\u03ac\u03b3\u03bd\u03c9\u03c3\u03b7\u03c2<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[42],"tags":[],"class_list":["post-19121","post","type-post","status-publish","format-standard","hentry","category-42","item-wrap"],"_links":{"self":[{"href":"https:\/\/evaggelatos.com\/index.php?rest_route=\/wp\/v2\/posts\/19121","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/evaggelatos.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/evaggelatos.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/evaggelatos.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/evaggelatos.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=19121"}],"version-history":[{"count":2,"href":"https:\/\/evaggelatos.com\/index.php?rest_route=\/wp\/v2\/posts\/19121\/revisions"}],"predecessor-version":[{"id":19123,"href":"https:\/\/evaggelatos.com\/index.php?rest_route=\/wp\/v2\/posts\/19121\/revisions\/19123"}],"wp:attachment":[{"href":"https:\/\/evaggelatos.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=19121"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/evaggelatos.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=19121"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/evaggelatos.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=19121"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}