A present-day drug, which has been used for the treatment of rheumatoid arthritis (RA) and related, excessive inflammatory conditions, will now be evaluated by Malaysia’s Universiti Malaya Medical Centre (UMMC) as a treatment for severe cases of COVID-19.
The Tocilizumab – trade name Actemra – trial is currently underway at UMMC, together with three public hospitals in Malaysia – the Sungai Buloh Hospital, Kuala Lumpur Hospital and Tuanku Ja’afar Hospital.
According to UM, the trial aims to compare the effectiveness of intravenous Tocilizumab in comparison to high-dose corticosteroids in about 300 COVID-19 patients who develop severe cases of the disease.
“We know that approximately 80% of COVID-19 patients have mild to moderate symptoms and will recover, however, 15% progress to severe disease and another 5% will develop critical illness, with death occurring in between 1 to 3% of patients,” said UM’s infectious diseases specialist, Professor Datuk Dr. Adeeba Kamarulzaman, who is leading the trial.
The adjunct associate professor at Yale University in US also said that the 5% stood to “develop signs and symptoms of a cytokine storm that leads to respiratory failure and the need for mechanical ventilation, after a week or two.”
A cytokine storm occurs when the immune system continues to release cytokines in an uncontrolled manner, long after the infection has been overcome.
“Ironically, it is their own immune response to the virus that kills them. We need to figure out how to safely turn off the overactive immune response as soon as it begins.”
On the bright side, Dr. Adeeba reveals that patients who develop the COVID-19 cytokine storm syndrome at UMMC have shown encouraging results after being treated with a high dose of Tocilizumab – the drug is specifically designed to block a critical component of the cytokine storm and may stop the progression of the disease into its most critical stage.
Out of eight severely ill patients, who received Tocilizumab, six were prevented from being ventilated and are now doing well.
“A big deal, considering the rate of deterioration of COVID-19 patients in China and Italy. Tocilizumab unfortunately did not work as well in the other two patients, as they were already very ill when the treatment was administered,” Dr. Adeeba lamented.
“We are grateful for the donation of Tocilizumab by Roche Malaysia that enabled us to treat the first few patients successfully,” Dr. Adeeba added – the Tocilizumab study will reportedly run for six months hereafter and will be joined by clinicians from Yale University.
The study team hopes to raise a total of RM1.5 million (US$346.1) for their cause; to date, less than 40% has been raised by a small group of private donors.