The World Health Organization (WHO) has updated its COVID-19 patient care guidelines to include interleukin-6 receptor blockers.
The WHO described the drugs as “lifesaving in patients who are severely or critically ill with COVID-19, especially when administered alongside corticosteroids.”
That conclusion was based on findings from a prospective meta-analysis initiated by WHO, which the organization says is the largest such analysis on the drugs to date. Data from over 10,000 patients enrolled in 27 clinical trials were analyzed and reported in a study in the Journal of the American Medical Association (JAMA).
WHO collaborated on the study with researchers from King’s College London, University of Bristol, University College London and Guy’s and St Thomas’ NHS Foundation Trust.
Patients severely or critically ill with COVID-19 often suffer from an overreaction of the immune system, and interleukin-6 blocking drugs — tocilizumab and sarilumab — act to suppress this overreaction.
The prospective meta-analysis showed that administration of the interleukin-6 blocking drugs was associated with lower 28-day all-cause mortality, compared with usual care or placebo.
The WHO said the study also showed that in severely or critically ill patients, administering these drugs reduce the odds of death by 13%, compared to standard care. This means that there will be 15 fewer deaths per thousand patients, and as many as 28 fewer deaths for every thousand critically ill patients. The odds of mechanical ventilation among severely and critically ill patients were reduced by 28%, compared with standard care. This translates to 23 fewer patients out of a thousand needing mechanical ventilation.
The improvements in outcomes were greater in patients who also received corticosteroids, according to a news release from King’s College London. "In these patients, the risk of dying within 28 days is 21% in patients receiving interleukin-6 antagonists, compared with an assumed 25% in patients receiving usual care," the college said.
Clinical trial investigators in 28 countries shared data with WHO, including pre-publication data. Researchers worldwide compiled and analyzed the data.
“These drugs offer hope for patients and families who are suffering from the devastating impact of severe and critical COVID-19. But IL-6 receptor blockers remain inaccessible and unaffordable for the majority of the world,” said WHO Director-General Tedros Adhanom Ghebreyesus, PhD.
