2023-07-16 07:49:51
If the COVID epidemic is on the decline, we must remember a current incidence of no less than 700 critical cases, per week, in France. Thus, by revealing that 2 anti-inflammatory drugs, abatacept and infliximab, reduce the number of deaths in patients hospitalized with severe COVID-19, this study will most likely contribute to meeting a lasting need for optimization of the treatment of these most vulnerable patients.
The study is a large clinical trial, called “ACTIV-1 Immune Modulator (IM)”, conducted on the effects of 3 drugs -infliximab, abatacept or cenicriviroc- commonly used to treat inflammatory diseases such as rheumatoid arthritis and psoriasis in the treatment of severe COVID-19. These anti-inflammatory drugs were tested as an adjunct to standard care vs standard care alone, in participants hospitalized with COVID-19. The drugs were administered in a single infusion. Standard care includes the antiviral drug remdesivir and the corticosteroid dexamethasone. The trial was conducted with 1,971 hospitalized patients at risk of serious complications including an aberrant immune response (cytokine storm).
Lead author Dr. William G. Powderly recalls the purpose of the trial: “One of the fundamental questions regarding COVID-19 is to understand how to attenuate the inflammatory process using existing anti-inflammatories. Our data suggest that 2 of the drugs studied may reduce mortality in these critically ill patients.”
Used in combination with standard treatments and treatmentsthese immune modulators do not affect recovery time but 2 of them, infliximab and abatacept, can significantly reduce the risk of death:
treatment with the third drug, cenicriviroc, was stopped prematurely because the data showed no benefit. 2 Beneficial Drugs for Severe COVID-Related Death: Marketed under the brand name Orencia, abatacept is an immunosuppressant used to reduce joint swelling, pain and fatigue associated with rheumatoid arthritis. It is given by infusion and works by reducing T cell responses; infliximab, known under the trade name Remicade, is an anti-inflammatory also used to treat rheumatoid arthritis in combination with methotrexate and severe chronic psoriasis, among other conditions. In participants with severe COVID treated with abatacept: 56 out of 509 patients died by day 28, a mortality rate of 11%; in the control group (placebo), 77 out of 510 patients died during the same period; i.e. a mortality rate of 15.1%; this 4.1% difference represents 21 fewer deaths in the group that received abatacept; in participants with severe COVID treated with infliximab, 52 of 517 patients had died by day 28, a mortality rate of 10.1% vs 14.5% in the control group; this 4.4% difference represents 23 fewer deaths among those who received infliximab.
These immune modulators used in conjunction with standard treatment, therefore, do not accelerate recovery but significantly reduce death rates in patients hospitalized with COVID-19.
These data will therefore make it possible to expand the therapeutic options available once morest COVID.
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