China has approved the rheumatoid arthritis drug Actemra (tocilizumab) for treatment of severe complications from COVID-19, the disease caused by the coronavirus known as SARS-CoV-2 which prompted the World Health Organization to declare a pandemic today.
Some COVID-19 patients develop severe cytokine release syndrome (CRS), also known as a “cytokine storm.” CRS essentially involves an overreaction of the immune system to a pathogen which triggers a runaway inflammation response. CRS can lead to organ failure and death.
Actemra treats rheumatoid arthritis by reducing inflammation. It specifically does this by inhibiting the high levels of Interleukin 6 (IL-6) protein which can cause inflammation. China’s National Health Commission said that Actemra can treat COVID-19 patients with severe lung damage and high levels of IL-6.
China is currently running a clinical trial of Actemra involving 188 COVID-19 patients which is expected to run until May 10. There is currently no clinical trial data available on the efficacy or safety of Actemra for treatment of COVID-19.
Iranian health ministry spokesman Kianoush Jahanpour said today that Iran is also testing tocilizumab as a COVID-19 treatment and that its first use in this regard led to an improvement of patient symptoms regarding oxygenation and chest radiography scans. Jahanpour said it is too early to judge the drug’s efficacy against COVID-19.
Italian oncologist Paolo Ascierto of Pascale Hospital in Naples said that tocilizumab “has shown it is effective against pneumonia caused by COVID-19.” Ascierto said the drug showed “excellent results” in two COVID-19 patients.
Over 125,000 cases of COVID-19 have been confirmed in over 120 countries and territories as of today. Over 4,600 confirmed COVID-19 deaths have occurred and there have been 67,000 confirmed recoveries from the disease. Major outbreaks of the disease have occurred in China, Italy, South Korea and Iran.
Those infected by SARS-CoV-2 can be asymptomatic. They can also develop symptoms like fever, cough, muscle pain, fatigue or shortness of breath. The virus sometimes leads to more severe symptoms like pneumonia, acute respiratory distress syndrome, sepsis, septic shock or death. The delay between infection and symptom onset can be as low as one day or as high as 27 days, but five days is the typical delay.
Actemra made the news in 2017 when an investigation found that the drug’s use may be linked to a higher risk of heart failure, pancreatitis, heart attack, stroke and interstitial lung disease.