Royal Surrey is recruiting patients to an international trial that has recently shown that treating critically ill Covid-19 patients with drugs typically used for arthritis significantly improves survival.
The findings, which have not yet been peer-reviewed, come from the REMAP-CAP trial, which evaluates the effect of treatments on a combination of survival and length of time patients need support in an intensive care unit (ICU).
Initial findings reported in November showed that tocilizumab, a drug used to treat arthritis, was likely to improve outcomes among critically ill Covid-19 patients. But the impact on patient survival and length of time on organ support in ICU was not clear at that time.
Now, the latest analysis shows that tocilizumab and a second drug called sarilumab – both types of immune modulators (which alter the body’s immune response) called IL-6 receptor antagonists – have a significant impact on patient survival, reducing mortality by 8.5%. This equates to one life saved in every 12 patients treated.
Furthermore, the treatment also improved recovery so that on average patients were able to be discharged from the intensive care unit (ICU) about a week earlier.
Royal Surrey is one of 290 sites worldwide taking part in the research. As part of the study, patients receiving treatment for Covid-19 have been offered the opportunity to participate in the REMAP-CAP study.
Participants receive one of multiple combinations of treatments that are randomly allocated by a computer. Clinicians record details about the patients and their response to the study treatment. This information is shared with the organisations leading the trial, Imperial College London and the Intensive Care National Audit & Research Centre (ICNARC) in the UK and University Medical Center Utrecht in Europe. Researchers can then evaluate different treatments for Covid-19 from a large pool of patients worldwide.
Ben Creagh-Brown, a consultant in intensive care medicine, regional lead for critical care research and the local lead for REMAP-CAP, said:
“The UK is leading the world at finding effective treatments for Covid-19 and we’re delighted that Royal Surrey is participating in several trials, including REMAP-CAP. Current patients are benefitting from the commitment of those who participated earlier, and patients continue to be offered a wide range of novel therapies.
“There is a long history of attempting to favourably modulate the immune response to infection and this is the first trial to have shown significant benefit.
“With these results, and adequate supplies of these monoclonal antibodies, we are confident that we can save lives and reduce the complications of critical illness from Covid-19. However, there’s more work to be done and I encourage people to participate in clinical trials – for themselves and for those that follow.”
The latest analysis is published in a pre-print available on medRxiv, with the findings submitted to a peer-reviewed journal.
The full press release about the study can be found on Imperial College London’s website