Tuesday, 28 April 2020
Tocilizumab, a drug already registered in Belgium and used mainly for the treatment of rheumatoid arthritis, has a beneficial effect on patients infected with the new coronavirus (Covid-19) and has helped over 50 patients so far.
The medicine is being investigated in clinical trials in Belgium, according to virologist and inter-federal Covid-19 spokesperson Steven Van Gucht.
Treatment with tocilizumab “significantly improved prognosis in patients with moderate to severe coronavirus,” and reduced the proportion of patients who had to be transferred to intensive care or died, compared to those who received standard treatment, according to a French study by the Assistance Publique-Hôpitaux de Paris (AP-HP), a university hospital system in Paris.
Anyone infected with the coronavirus can go through several stages of the disease. In the first week, the virus is already active, and this activity caused the patient to become ill, as the virus multiplies in the body. In the second week, the immune system controls the disease more, according to Van Gucht.
“When there is an excessive reaction of the immune system to the coronavirus, the immune system causes a lot of damage in the lungs, making it difficult to breathe,” said Van Gucht during the daily press conference on Tuesday, adding that this caused severe complications.
“A lot of molecules, which are going to influence and weaken that immune system, are currently being experimented with. Tocilizumab is one of them,” Van Gucht said. “A number of clinical studies have already found that it can have a beneficial effect on the further course of the disease,” he added.
In most cases, the body’s immune system fights the virus, clears it from the body, and the person recovers, according to professor Bart Lambrecht of the university hospital in Ghent.
“However, there is a group of patients for who it works differently. Around day ten, we see a turnaround. They’re getting worse,” Lambrecht told Het Laatste Nieuws. “The reason: their immune system reacts too much. It continues to fight while the virus is already gone. Then all of a sudden there are all sorts of complications: blood clots, or white spots on the lung photo that indicate damage,” he added.
Those patients are in need of a medicine that stops these reactions by their immune system. “Tocilizumab already does that for patients with rheumatism, which is also an inflammatory disease, caused by an overreaction of the immune system,” Lambrecht said.
In general, these complications occur mainly in relatively young coronavirus patients. “Elderly people usually die from fever and getting weaker,” said Lambrecht. “When younger patients, those in their forties, fifties or sixties, become severely ill or die, it’s because their immune system goes into overdrive. We do not know why some suffer from these complications and other ones don’t. Presumably, heredity plays a role,” he added.
More than 50 Belgian patients have already received experimental treatment with tocilizumab, according to Lambrecht. “We are not doing a blind study, so we already know that the results are promising,” he said.
In time, 342 patients who are participating in the study will receive the medication for rheumatism. “It was the only way to treat them with it,” said Lambrecht. “Apart from the study, there is no reimbursement scheme for the drug,” he added.
The Brussels Times