Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

The Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial has demonstrated that tocilizumab, an anti-inflammatory treatment, reduces the risk of death when given to hospitalised patients with severe COVID-19. The study also showed that tocilizumab shortens the time until patients are successfully discharged from hospital and reduces the need for a mechanical ventilator.

Vial of tocilizumab

The RECOVERY trial has been testing a range of potential treatments for COVID-19 since March 2020. Tocilizumab, an intravenous drug used to treat rheumatoid arthritis, was added to the trial in April 2020 for patients with COVID-19 who required oxygen and had evidence of inflammation. Recruitment to the tocilizumab arm stopped on 24 January 2021 since, in the view of the trial Steering Committee, sufficient patients had been enrolled to establish whether or not the drug had a meaningful benefit.

A total of 2022 patients were randomly allocated to receive tocilizumab by intravenous infusion and were compared with 2094 patients randomly allocated to usual care alone. 82% of patients were taking a systemic steroid such as dexamethasone.

Treatment with tocilizumab significantly reduced deaths: 596 (29%) of the patients in the tocilizumab group died within 28 days compared with 694 (33%) patients in the usual care group (rate ratio 0·86; [95% confidence interval [CI] 0·77 to 0·96]; p=0·007), an absolute difference of 4%. This means that for every 25 patients treated with tocilizumab, one additional life would be saved. Tocilizumab also increased the probability of discharge alive within 28 days from 47% to 54% (rate ratio 1·23, [95% CI 1·12 to 1·34], p<0·0001). These benefits were seen in all patient subgroups, including those requiring oxygen via a simple face mask through to those requiring mechanical ventilators in an intensive care unit.

Among patients not on invasive mechanical ventilation when entered into the trial, tocilizumab significantly reduced the chance of progressing to invasive mechanical ventilation or death from 38% to 33% (risk ratio 0·85, [95% CI 0·78 to 0·93], p=0·0005). However, there was no evidence that tocilizumab had any effect on the chance of successful cessation of invasive mechanical ventilation.

Peter Horby, Joint Chief Investigator for RECOVERY, said ‘Previous trials of tocilizumab had shown mixed results, and it was unclear which patients might benefit from the treatment. We now know that the benefits of tocilizumab extend to all COVID patients with low oxygen levels and significant inflammation. The double impact of dexamethasone plus tocilizumab is impressive and very welcome.’

Read the full story on the RECOVERY Trial website.

Similar stories

Arjen Dondorp, Peter Horby and Rose McGready elected Academy of Medical Sciences Fellows

Awards & Appointments MORU OCGHR

"Although it is hard to look beyond the pandemic right now," says President of the Academy of Medical Sciences Professor Dame Anne Johnson, "I want to stress how important it is that the Academy Fellowship represents the widest diversity of biomedical and health sciences. The greatest health advances rely on the findings of many types of research, and on multidisciplinary teams and cross-sector and global collaboration."

We gathered rich insights into child survival in Kenya by mapping patterns over 22 years

KWTRP Research

Although improvements in child survival globally have been remarkable, 5.2 million children still died in 2019, over half of these in sub-Saharan Africa. A range of factors likely include disparities in childhood immunisations, supplements and breastfeeding practices, antenatal care, skilled birth attendants working in healthcare facilities. Kenya needs to prioritise its child care plans, based on localities and populations with the greatest need. Two KWTRP studies give granular insights into the situation in regions across Kenya.

Risks of serious adverse events following treatment for visceral leishmaniasis

OCGHR Publication Research

This large-scale systematic review and meta-analysis aimed to collate all reported serious adverse events in visceral leishmaniasis clinical trials and quantify the incidence of mortality during the first 30 days of therapy. The analyses, which included clinical data from more than 35,000 patients, found that mortality following treatment was an extremely rare event and serious adverse events following treatments were poorly reported.

The RECOVERY Trial: One year on

OCGHR Research

The Randomised Evaluation of COVid-19 thERapY (RECOVERY) trial was officially launched on 23 March 2020. It is the world's largest COVID-19 drug trial. Thanks to the ground-breaking work of RECOVERY, clinicians treating patients hospitalised with severe COVID-19 now have two treatments that are known to improve survival.

Researchers call for access to Ivermectin for young children

OCGHR Publication Research

Millions of children weighing less than 15kg are currently denied access to Ivermectin treatment due to insufficient safety data being available to support a change to the current label indication. The WorldWide Antimalarial Resistance Network’s new meta-analysis provides evidence that supports removing this barrier and improving treatment equity.

Gender imbalance in visceral leishmaniasis clinical trials

OCGHR Publication Research

Researchers have found that despite an ongoing trend for a decreasing proportion of males being enrolled in antileishmanial therapeutic efficacy trials over time, there are still 1.8 times as many males as females involved in clinical trials. A new systematic review and meta-analysis suggests that existing knowledge on drug efficacy is derived from a study population that is heavily skewed towards adult males. At the same time, substantially less is known about the optimal treatment response in female patients.