Qld researchers to trial arthritis drug in critical COVID-19 patients

Queensland is home to a trial to test the benefits of a rheumatoid arthritis drug in critically ill COVID-19 patients.

QUEENSLAND researchers are preparing to launch a trial of a rheumatoid arthritis drug in critically ill patients with COVID-19, hoping it will dampen down the life-threatening inflammation in their lungs.

The QIMR Berghofer Medical Research Institute trial will compare the outcomes of COVID-19 patients in intensive care units treated with the drug tocilizumab with those given standard care.

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Although Australia’s success in flattening the curve of new coronavirus cases has created welcome issues with recruiting patients for COVID-19 studies, the QIMR Berghofer scientists have decided to push ahead with the research in intensive care unit patients to give them the opportunity of taking part in the trial.

Infectious disease specialist Associate Professor Bridget Barber, who is leading a study for the QIMR Berghofer Medical Research Institute involving COVID-19 patients. Picture Supplied

Lead researcher Bridget Barber, who is also an infectious disease physician at the Royal Brisbane and Women’s Hospital, said a small study of the drug in Italy had shown promising early results, but more research was needed to provide definitive information before it could be routinely prescribed by doctors.

Tocilizumab, marketed in Australia as Actemra, works by blocking an immune system molecule called Interleukin 6, or IL6, which causes inflammation, and is thought to contribute to the severe respiratory failure that occurs in some patients with the pandemic virus.

Associate Professor Barber said high levels of the inflammatory molecule IL6 had been detected in critically ill COVID-19 patients.

“Intensive care units around the world have reported that many patients deteriorate about a week after they experience the first symptoms of COVID-19,” Professor Barber said.

“Other studies have shown an increase in the patients’ inflammatory response around that time, including high levels of IL6.

“We think it’s this inflammatory response – caused by some parts of the immune system overreacting to the virus – that is making these patients so unwell.

“We hope that tocilizumab will improve outcomes in critically ill patients by blocking this key inflammatory molecule IL6, and preventing some of the damage that is caused by this inflammatory response.”

Professor Barber said other trials into the effectiveness of tocilizumab in COVID-19 patients were being conducted internationally.

She said although Australia had seen a big fall in cases of the new virus, small numbers of infections were expected to continue and require admission to an ICU.

“Even if we do have a small number of cases, we think it’s worthwhile proceeding so that those critically ill patients have the opportunity to be in the trial,” Professor Barber said.

“In addition, we need to be prepared for the possibility that cases may increase again at a later stage.”

The trial will initially involve patients at the Royal Brisbane and Women’s Hospital and other hospitals in the Metro North Hospital and Health Service district.