Tocilizumab reduces deaths in hospitalised COVID-19 patients

A new trial has found that tocilizumab, an anti-inflammatory treatment, reduces the risk of death in patients hospitalised with COVID-19

The ‘Randomised Evaluation of COVID-19 thERapY’ (RECOVERY) trial has found that tocilizumab can be used to decrease the risk of death in patients hospitalised with COVID-19 and shorten the time until patients can be discharged, reducing the need for a mechanical ventilator.

2022 patients were randomly selected to receive tocilizumab by intravenous infusion and were compared with 2094 patients randomly selected to usual care alone. 82% of patients were taking a systemic steroid such as dexamethasone.

596 (29%) of the patients in the tocilizumab group died within 28 days compared with 694 (33%) patients in the usual care group, a difference of 4%. This means that for every 25 patients treated with tocilizumab, one additional life would be saved.

Tocilizumab also increased the likelihood of discharge within 28 days from 47% to 54% and significantly reduced the chance of progressing to invasive mechanical ventilation or death from 38% to 33%.

Wendy Coleman (62) received tocilizumab through the RECOVERY trial last year when she was admitted to Chesterfield Royal Hospital with severe COVID-19.

“I was struggling to breathe quite badly and on the verge of being placed in an intensive care unit when I was asked if I wanted to take part in the RECOVERY trial. After I was given tocilizumab, my condition stabilised and I didn’t get any worse. Up until then, it was quite scary as I didn’t know if I was going to make it or not.

“I’d like to thank those who run the RECOVERY trial, besides all the staff at the Royal Hospital at Chesterfield. You never think about clinical trials, until you are in need of these treatments and then you realise what happens behind the scenes to find out if they work.”

Professor Peter Horby,  from the University of Oxford, and Joint Chief Investigator for RECOVERY, said:

“Previous trials of tocilizumab had shown mixed results, and it was unclear which patients might benefit from the treatment. We now know that the benefits of tocilizumab extend to all COVID patients with low oxygen levels and significant inflammation. The double impact of dexamethasone plus tocilizumab is impressive and very welcome.”

Professor Martin Landray, from the University of Oxford, and Joint Chief Investigator, said:

“The results from the RECOVERY trial clearly show the benefits of tocilizumab and dexamethasone in tackling the worst consequences of COVID-19 – improving survival, shortening hospital stay, and reducing the need for mechanical ventilators.

“Used in combination, the impact is substantial. This is good news for patients and good news for the health services that care for them in the UK and around the world. We simply would not know this if it wasn’t for the incredible support of NHS patients and staff in the most challenging of circumstances.”

The trial has been funded by the COVID-19 rapid research response by UK Research and Innovation (UKRI) and the National Institute for Health Research (NIHR).