However, the fourth trial found an increased chance of the drug surviving, but because it was an observational study, the results were considered less conclusive.
Three trials were published on Tuesday in the Journal of the American Medical Association and another on Wednesday in the New England Journal of Medicine.
While this picture leaves a muddy picture for use, the accompanying study showed that the drug is not a magic bullet that should be used in all hospitalized patients with Covid-1, but they open the door to the potential use of a particular patient. Leaves. Groups.
“It is likely that the forthcoming results of other randomized trials will help us identify specific groups of people who will benefit. However, the growing evidence supports the current guidelines, which recommend against the use of tisilizumab outside of clinical trials,” said Dr. Jon. Said.
Toc silizumab, sold under the brand name Tem Ktemera and used to treat arthritis, inhibits interleukin-6, which causes inflammation.
At the onset of the epidemic, the drug was widely used in the United States, when reports from China and Europe showed that it helped very sick patients who experienced a so-called cytokine storm, which controlled the exacerbated inflammation. Corona virus.
The results of the study begin to come
However, those initial reports were mostly observational, meaning they took data that existed and analyzed it specifically in opposition to designing a trial to evaluate Tosilizumab.
But now the results of trials designed to see the drug as possible are beginning to come to light.
But because it is an observational trial there may be factors that could affect the results other than how the drug itself works.
“We have studied Tosilizumab administration, especially in very sick patients, all of whom require ICU-level care. In contrast, [other two trials] “Studied patients with debilitating disease severity,” said Dr. Brigham and Women’s Hospital of Boston, who led the study team. Shruti Gupta said.
Dr. David, senior author of the trial. David Leaf added, “We focused on the initial use of tocilizumab within the first two days of ICU admission. This may be the key to the effectiveness of tocilizumab – administering it before the occurrence of an irreversible organ injury,” he said in an email.
Gupta said his findings need to be confirmed by a large randomized, controlled trial.
It enrolled 243 patients from seven hospitals in the Boston-area who were admitted to the area with Covid-19 at the height of the surge.
“The primary goal of the trial was to determine whether to allow patients to enter the veins in the middle stages of the disease, if endocrine or prevent the progression of death,” said Dr. John H. Stone, director of clinical rheumatology. At Massachusetts General Hospital, told CMN by email.
But the findings were not encouraging for the use of Tosilizumab.
“Our data do not support the notion that early IL-6 receptor blockade is an effective treatment strategy in hospitalized moderately ill patients with covid-19 infection,” Stone said.
The results showed that the probability of coma or death was the same in both groups and patients in both groups took the same amount of time to turn off supplemental oxygen.
So, where does it leave tocilizumab?
“The said Silizumab could still play a role in COVID-19. Some big trials are expected to come out soon that will tell us how and when to use it, if not at all,” Parle said. It should not be completely removed from the table, but we need more convincing evidence before using it regularly. “
Stone agreed that the drug could still benefit other patient groups, but he stressed the importance of doing these tests.
“An important point of our trial and the overall experience of IL-6 receptor blockade is that any such approach to the treatment of COVID-19 should be a randomized, blind trial,” he added.
.
