Recent COVID-19 trial results suggest the arthritis drug Kevzara may only help critically ill COVID-19 patients whereas the arthritis drug Actemra may help a broader range of COVID-19 patients.
A Sanofi and Regeneron trial showed that Kevzara seemed to improve the clinical outcomes of severely ill COVID-19 patients, but that less severely ill COVID-19 patients actually did slightly worse by a statistically insignificant margin on the drug. A study on 276 less severely ill patients, belonging to a “severe” group who needed oxygen but not high-flow oxygen or ventilators, was stopped as there was zero chance it would be successful.
A separate “critical” group of patients who needed high-flow oxygen or ventilators saw an additional 1 in 10 patients who received Kevzara being discharged from the hospital compared to a group that received placebo. The researchers are continuing a larger study to further investigate this benefit.
In the Actemra trial run by researchers at Assistance Publique – Hopitaux de Paris, 129 patients who had moderate or severe COVID-19 pneumonia but did not require ventilators were studied. 64 were given usual treatment and 65 were given usual treatment plus Actemra. A significantly lower percentage of patients given Actemra ended up requiring ventilators or dying compared to the patients who were not given Actemra.
”This is very important,” said Olivier Hermine of Necker Hospital in Paris. “We have reduced significantly the transfer of patients from classical wards to intensive care units.”
COVID-19 patients are known to develop cytokine release syndrome, often referred to as a “cytokine storm.” This is essentially an uncontrolled inflammation response by the body’s immune system. Actemra and Kevzara are being studied in relation to COVID-19 treatment because they block IL-6, an inflammatory cytokine. It is hoped they can reduce lung inflammation caused by cytokine storms in COVID-19 patients.
Actemra is currently being studied in other COVID-19 trials as well, including a University of Oxford study involving over 6,000 COVID-19 patients and a phase 3 trial in the United States by Roche and the US Biomedical Advanced Research and Development Authority. Chinese doctors recently saw a 95% success rate in treating COVID-19 with Actemra.
The FDA has previously warned that Actemra could be associated with pulmonary alveolar proteinosis, interstitial lung disease and pulmonary hypertension. Actemra has also been associated with risks of liver failure and pancreatitis, as well as 1.5 times the risk for heart failure and stroke.