Trial results show potential benefits of tocilizumab for COVID-19

Tocilizumab (TCZ) is one of multiple drugs that have been studied in clinical trials around the world as a potential treatment for COVID-19. A team of international researchers present their results from the COVACTA trial in the New England Journal of Medicine (NEJM).

Baylor College of Medicine was one of the research sites for COVACTA, which evaluated the therapeutic benefit and safety of tocilizumab, an immunomodulator drug, in patients with severe COVID-19 pneumonia. Findings suggest that tocilizumab treatment can improve the duration of hospitalization and need for an ICU ventilator.

“The trial suggests that you are less likely to have a future need of a ventilator if you are admitted to the hospital for treatment,” said Dr. Ivan O. Rosas, chief of pulmonary, critical care and sleep medicine in the department of medicine at Baylor College of Medicine and the lead author of the study. “Although we did not find a significant improvement in clinical status, the study’s primary endpoint, reducing the number of hospital days is important for patients and for our healthcare system.”

COVACTA enrolled 452 participants in nine countries. Dr. Nicola Hanania and Dr. Kalpalath Guntupalli led enrollment at two Baylor affiliates, Baylor St. Luke’s Medical Center and Ben Taub Hospital. Baylor was the top enrolling site in this multi-center clinical trial.

In addition to COVACTA, Dr. Lavannya Pandit and Dr. Barbara Trautner, Baylor and Michael E. DeBakey VA Medical Center investigators, participated in EMPACTA, another trial that studied the impacts of tocilizumab in patients with COVID-19 pneumonia. In this study, tocilizumab reduced the likelihood of needing a ventilator but did not improve survival. These findings are supported by recent reports of large open-label trials of tocilizumab in the United Kingdom, which suggest a positive treatment effect, including improvements in survival.

Findings from both clinical trials suggest that tocilizumab has a beneficial role in patients affected with COVID-19 pneumonia. Rosas adds that additional studies can help further define which patients will benefit the most from this treatment. In the coming weeks, results are expected from the REMDACTA trial, which is studying the effects of tocilizumab in combination with remdesivir, an FDA approved anti-viral therapy for COVID-19.