A team of Indian-American scientists has found that patients experiencing severe Covid-19 symptoms had improved outcomes when administered an Interleukin-6 (IL6ri) inhibitor, sarilumab or tocilizumab — used in treating autoimmune diseases like rheumatoid arthritis (RA) and other several inflammatory conditions.
The treatment was more effective when administered earlier in the disease course, reducing mortality rate and the need for intubation.
Published in the International Journal of Infectious Diseases, the results showed that Interleukin-6 inhibitors appear to be a more effective treatment method as compared to other options, including remedesvir and dexamethasone, which are recommended and are being currently used to check the pandemic.
“At a time when treatments are being tested with urgency amid the Covid-19 pandemic, our study results offer some hope towards finding solutions to better treat patients infected by this disease,” said study researcher Manish Sagar from Boston University.
According to the study, elevated IL-6 levels may mediate the severe systemic inflammatory responses that occur in patients with severe acute respiratory syndrome or Covid-19 infection.
The observational study included 255 Covid-19 patients being treated with IL6ri during stage IIB (149 patients) and stage III (106 patients) of the disease.
Once an appropriate patient was identified, he/she was given IL6ri (sarilumab or tocilizumab) based on iteratively reviewed guidelines.
The IL6ri was initially reserved for critically-ill patients, but after review, the treatment was liberalized for patients with lower oxygen requirements.
The IL6ri recipients had considerably higher supplementary oxygen requirements, indicating more advanced disease than patients in previous remdesivir and dexamethasone trials, and would have been expected to have a higher mortality rate.
The study’s sampling-with-replacement analysis found that the patients who received IL6ri had a lower mortality rate than patients in the intervention and control groups of remdesivir and dexamethasone trials.
The 22.9 percent mortality rate for the 105 Boston Medical Center patients that required ICU care (41.1 percent) was considerably lower than previously published 45-50 percent mortality in other ICU studies.
“The greatest benefit of IL6ri use was seen in patients who received the drug in an earlier stage, prior to critical respiratory decompensation, showing the importance of prompt testing and treatment,” said study researcher Pranay Sinha.
“We hope these findings can help guide physicians as we seek solutions to reduce mortality, increase extubation, reduce the length of stay in the hospital, and have more patients discharged from the hospital alive,” Sinha added.