Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. 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

Pilot study detects diverse DNA in ingredients of falsified tablets

A recent multidisciplinary pilot study, originating from LOMWRU and the Medicine Quality Research Group of IDDO and MORU, investigated whether bacterial, plant, fungal and animal DNA in the ingredients and from the environment (eDNA) could be detected from falsified (aka counterfeit) tablets.

Expert Comment: Biotechnology allows us to make unprecedented interventions for conservation

In the wake of high-profile reports on the devastating toll human activity has had on global biodiversity, nations are expected to adopt the Convention on Biodiversity post-2020 framework that outlines measures to ensure humans live in harmony with nature.

Researchers call for antimicrobial resistance surveillance to be improved

The number of studies reporting antimicrobial resistance (AMR) data has increased in Africa, South and South East Asia according to new research in the International Journal of Infectious Diseases.

Meta-analysis informed the updated WHO guidelines for treatment of uncomplicated malaria in the first trimester of pregnancy

A new WWARN meta-analysis, commissioned by the World Health Organization and which informed a change to its treatment guidelines, has been published in The Lancet. The study provides compelling evidence that artemether-lumefantrine should now replace quinine as the treatment of choice in the first trimester.

Bacterial infections linked to one in eight global deaths, according to GRAM study

Data showing 7.7 million deaths from 33 bacterial infections can guide measures to strengthen health systems, particularly in low-income settings

GRAM visualization tool tracks country-level AMR and related metrics

Interactive app allows users to explore data underlying estimates of global AMR burden