French trial shows arthritis drug tocilizumab 'can help treat Covid-19 pneumonia'

29 April 2020, 11:56

Buses and trams in the Bordeaux region are disinfected three times a day to prevent the spread of covid-19
Buses and trams in the Bordeaux region are disinfected three times a day to prevent the spread of covid-19. Picture: PA
Matthew Thompson

By Matthew Thompson

A French trial for an arthritis drug has shown encouraging results for the treatment of severe coronavirus cases.

The small study, that is not yet peer-reviewed, found that the arthritis drug tocilizumab, which is also undergoing trials here in the UK, “significantly improves clinical outcomes of patients with moderate or severe COIVD-19 pneumonia,” according to its authors.

One of the main causes of severe illness and death in patients with COVID-19 pneumonia is an immune reaction known as a “cytokine storm” which can cause acute respiratory failure.

It is a common feature of autoimmune diseases, such as arthritis, but can also be triggered by infections such as influenza, and Covid-19.

Researchers have hoped for some time that existing drugs may be able to help control this dangerous immune response.

The French study, led France’s largest hospital trust, Assistance Publique - Hôpitaux de Paris, involved 129 patients. 65 of them received tocilizumab, and 64 were in the control group. The scientists said “a significantly lower proportion” of the patients who were given the drug required ventilation or subsequently died within 14 days.

However, the exact details have not yet been made public, as the scientific paper has been submitted for publication in a peer reviewed journal – an important part of ensuring scientific accuracy.

One of the lead investigators, Professor Xavier Mariette, said: “There have been several small open studies, with interesting results, but ours is the first randomised control trial that demonstrates a benefit of tocilizumab. Of course, even if we’re the first, this trial needs to be confirmed. Before we can validate the results definitively and scientifically, further randomised control trials will have to confirm this initial data.”

The hospital said in a statement said that “given the pandemic context, the investigators and sponsor felt ethically obligated to disclose this information" prior to it being peer-reviewed.

Professor Munir Pirmohamed, President of the British Pharmacological Society, was sceptical. He told LBC the findings were “encouraging,” but warned: “This has been done before the study has been peer reviewed and published in a journal. It’s also important to note that this was a small trial, only 65 patients were treated with tocilizumab.

“There are very few details given on the type of patients which were treated, and whether they suffered any side effects. We therefore need to wait for the study to be published in its entirety, and for the larger trials which are ongoing in the UK, EU countries and in the US.”

The peer review process usually takes around 3 to 4 weeks, but given that all journals are currently prioritising coronavirus-related studies, it may be much sooner than that. Some scientists are currently being asked to peer review studies in a matter of days.