A drug used to treat rheumatoid arthritis could help save the lives of patients with severe Covid, researchers have found, and they say its benefits can be seen even when used in addition to other drugs.
Experts involved in the randomized evaluation trial of Covid-19 therapy (recovery) say baricitinib, an anti-inflammatory drug taken as a tablet, can reduce the risk of death from severe Covid by around a fifth .
However, they add that when the impact of other drugs used alongside the drug is also taken into account, the risk of death could be reduced by more than 50% – although the figure varies from patient to patient.
“What we have now is a suite of drugs that attack the immune system at different levels, and in slightly different ways, which depending on the patient and their situation, their other illnesses, etc., can be used alone or in combination and further reduce the risk of death,” said Professor Sir Martin Landray, co-chief investigator of the trial at the University of Oxford. He said the drugs did not appear to pose any risks industrial.
Writing in a preprint that has yet to be peer-reviewed, the team reports how it looked at the outcomes of 4,008 patients hospitalized with Covid between February and December 2021 who received usual care – which included interventions such as oxygen, the steroid dexamethasone, the arthritis drug tocilizumab, which must be given intravenously, and the antiviral drug remdesivir.
These results were compared with those of 4,148 patients who received baricitinib for up to 10 days in addition to usual care.
The results reveal that 546 patients receiving usual care died within 28 days of hospital admission and 513 patients who also received baricitinib.
“This result was consistent across the very wide range of people we studied, young and old, male and female,” Landray said.
Landray noted that people receiving bariacitinib were also more likely to be successfully discharged alive within the first 28 days, although the magnitude of the effect was small and less likely to require mechanical ventilation.
The team says that when the new results are combined with data from other trials, all of which were smaller than the Recovery trial, they found that baricitinib reduced the risk of death in hospitalized patients by around a fifth. for Covid.
The researchers say that neither patients’ vaccination status nor when patients entered the trial – which can encompass different variants of Covid – seemed to affect the results.
Although concerns have previously been raised by studies of long-term users of baricitinib that the drug may increase the rate of infections or blood clots, the researchers say that there were no signs of such side effects. found when used over a short period to help tackle severe Covid.
Landray said a 10-day course of baricitinib would cost around £250, which would make the drug more expensive than dexamethasone, which costs around £5 for a course, but cheaper than tocilizumab, which costs around £800 to £1,000, although he noted it was likely prices paid by the NHS would be lower.
While tocilizumab works to block a protein that can cause the immune system to overreact, baricitinib blocks the signaling of this and similar proteins.
Professor Sir Peter Horby, also co-chief investigator of the Recovery trial, said the results were also important given that some variants of Covid are resistant to certain antivirals.
Sajid Javid, the UK health secretary, welcomed the latest baricitinib results. “This is promising news from the government-funded Recovery trial and shows once again how the UK is leading the world in identifying life-saving treatments for NHS patients,” he said. declared. “A big thank you to all the researchers, doctors and volunteers involved in this work. Our medical and scientific experts will now review the results before making decisions on next steps. »