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Is tocilizumab (Actemra) effective for treating COVID-19?

Medically reviewed by Melisa Puckey, BPharm Last updated on Apr 12, 2020.

Official Answer

by Drugs.com

Is Tocilizumab (Actemra) effective for treating COVID-19?

  • Tocilizumab  (Actemra) is being studied in Italy for patients with pneumonia from COVID-19 (coronavirus), after the AIFA (Italian Medicines Agency) gave approval for trials. This study is called TOVICID-19.
  • Early patients in Italy who had their COVID-19 pneumonia treated with tolicizumab seemed to show improvement, however the medicine must be tested on many people to see whether it will be effective, without excessive side effects.
  • Genentech, which is a member of the Roche Group has a randomized double-blind, placebo controlled trial for treating severe pneumonia caused by COVID-19. This study called COVACTA, started 3 April 2020.

What is Tocilizumab (Actemra) ?

Immunosuppressant

Interleukin-6 (IL-6) receptor antagonist

How does Tocilizumab (Actemra) work on COVID-19?

  • Very simply it is thought to reduce the amount of inflammation in the lungs caused by coronavirus, so it may help with breathing problems in COVID-19.
  • If you become infected with coronavirus, your immune system sends useful immune chemicals to the affected areas of the lungs to help fight the infection, which is good because this is how you recover from an infection.  However in some people there is an overreaction by the immune system (called a ‘cytokine storm’) causing too many immune chemicals arriving in the lungs. The lungs become very inflamed and can no longer work properly, which causes severe breathing problems and can in some cases have led to death in Covid-19 patients.
  • Tocilizumab works to reduce this rush of immune chemicals to the affected area, and means there is less inflammation and damage to the lungs. The actual way it does this is by blocking the Interleukin-6 (IL-6) receptor.
  • Once the IL-6 receptor is blocked by Tocilizumab, then there will be a dampening down of the inflammation and immune response, this means the body will  hopefully be able to recover better.

Is Tocilizumab (Actemra) an approved medicine by the FDA?

  • Yes, tocilizumab has been approved by the FDA for these conditions, rheumatoid arthritis, giant cell arteritis, polyarticular juvenile idiopathic arthritis, systemic juvenile idiopathic arthritis, and cytokine release syndrome (CRS).
  • Tocilizumab is not approved for use in treating COVID-19 complications, however it is currently in clinical trials for treatment of COVID-19 complications.

What happens next?

We need to wait for the trials to be completed to find out how well tocilizumab works to decrease any breathing and lung issues in COVID-19, and whether it speeds up patients recovery.

The studies will also be looking for any side effects or any unexpected issues that may reduce  tocilizumab usefulness in COVID-19 patients

Bottom line

  • Tocilizumab is one medication that is currently being trialled to treat patients with respiratory or breathing complications from COVID-19.
  • Tocilizumab is thought to decrease the ‘cytokine storm’ or excessive immune response within the lungs in patients with COVID-19.
  • Tocilizumab is not currently approved by FDA for COVID-19 complications and is in the clinical trial stage of development.
References
  • https://www.bmj.com/content/368/bmj.m1086.full
  • https://clinicaltrials.gov/ct2/show/NCT04320615
  • https://clinicaltrials.gov/ct2/show/NCT04317092
  • https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30628-0/fulltext
  • https://www.gene.com/media/press-releases/14843/2020-03-23/genentech-announces-fda-approval-of-clin
  • https://www.tellerreport.com/news/2020-03-16---coronavirus--ok-to-the-trial-of-the-drug-tolicizumab-.ryOLOB6S8.html

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