Is tocilizumab a good lightning rod?
Faced with the coronavirus, does this drug help calm the immune storm that sometimes plays out in our body, to the point of aggravating the disease?
“I would say that it is one more tool in the therapeutic arsenal against the Covid but that we must go further in the studies”, summarizes Professor Yazdan Yazdanpanah, head of infectious diseases at the Parisian hospital Bichat ( XVIII e).
At the end of April, this molecule, administered since 2010 to patients suffering from rheumatoid arthritis, had been talked about.
The Hospitals of Paris (AP-HP) had rushed their communication, citing a "significant improvement in the prognosis of patients" hospitalized with moderate to severe Covid pneumonia.
In the process, the independent committee in charge of monitoring the study resigned, protesting against the results given before the trial was completed.
A trial with few patients
Now it is and its findings were published on Tuesday in the prestigious scientific journal Jama.
If no difference in mortality is observed at 28 days, tocilizumab, on the other hand, reduces the risk of being admitted to intensive care by 50% and of being intubated by 33%.
However, we know that the after-effects of intubation can be serious.
In addition, the treatment did not cause any adverse effects.
Hope, good news, but the Corimuno-Toci trial remains small, with “only” 130 patients included.
"We walk staircase by staircase, today we need assessments on a larger scale", decrypts Professor Yazdanpanah.
The same day, other studies were also published, including a sharp Italian: no beneficial effect to tocilizumab.
Faced with these diverse and mixed results, it is therefore too early to launch a cocorico, but tocilizumab is on the track again as a serious candidate for treatment in the face of certain forms of the disease.
A study in combination with corticosteroids
More than corticosteroids, such as dexamethasone, which we now know that they reduce mortality by 21%?
"Both intervene on the whole inflammation part, but only corticosteroids are now fully validated", underlines Yazdanpanah.
The doctor does not rule out anything, including that a combination of the two treatments could have an even more beneficial effect for the patients.
The aptly named "TociDex" trial has started to verify this.
