An arthritis drug does not significantly increase the survival rate of a severe COVID-19 patient, a new study finds.
Researchers at 39 U.S. and European hospitals examined the drug, called canakinumab, and found a difference of only three percent in survival rates without a ventilator between the patients treated with the medication and not.
Overall survival and recovery rates were also comparable between the patients who did and did not receive canakinumab.
The drug is a type of monoclonal antibody – it is based on synthetically made immune system particles.
While some monoclonal antibodies have been helpful in treating COVID-19 patients, not all treatments are successful, and the team says more research is needed in this area.
Monoclonal antibody treatment used for arthritis has proven ineffective in severe Covid patients, new study finds
Patients who received the arthritis drug had similar chances of surviving without a ventilator (IMV) or going home from the hospital compared to those who did not receive it
While researchers have tried to find treatments that help save the lives of Covid patients, a common strategy is to repurpose drugs used against other diseases.
For example, the antiviral drug remdesivir was first developed to treat hepatitis C. It is now one of the most widely used in-hospital Covid treatments.
Monoclonal antibodies are another common drug type, developed in the 1980s and 1990s. t
his treatment uses artificially made antibodies — pieces of the immune system — to increase a patient’s ability to fight disease.
The Food and Drug Administration (FDA) has: given authorization for emergency use to various monoclonal antibody treatments targeting Covid.
Researchers are now investigating other, similar treatments — including canakinumab, a monoclonal antibody treatment commonly used to treat a condition of childhood arthritis.
A new study from an international group of researchers found that this arthritis drug did not successfully improve the survival rates of critically ill Covid patients.
The research group included physicians from 39 hospitals in the US and Europe, led by a physician at the Lewis Katz School of Medicine at Temple University with findings published in JAMA . on Tuesday.
Based on lab experiments and results from other similar monoclonal antibody treatments, the researchers hypothesized that canakinumab would help reduce inflammation and organ damage in critically ill Covid patients.
The researchers tested this arthritis drug through a randomized, double-blind, placebo-control study — meaning patients were randomly assigned to receive the drug or a placebo without knowing which one they were getting.
To qualify for the study, patients had to be hospitalized with a positive Covid test, Covid-related pneumonia, low oxygen levels and inflammation.
In total, approximately 450 patients participated. The group consisted of half men and half women, mostly middle-aged and older.
In addition to the arthritis drug or placebo, patients continued to receive standard Covid care in their hospitals.
The researchers followed the patients for a month and then continued the follow-up after the patients went home from the hospital.
The researchers found no significant differences in disease severity between the drug group and the placebo group over the course of the study
Within that first month, patients in the drug and placebo groups had similar survival rates.
Of the 223 patients in the canakinumab group, 198 (88.8 percent) survived without a ventilator. And of the same number of patients in the placebo group, 191 (85.7 percent) survived without a ventilator.
That is a difference of only 3.1 percentage points between the two groups. To see a significant improvement to the drug, the researchers hoped to see a 15-point difference.
The number of deaths and recovery was also comparable between the groups. In the canakinumab group, 11 patients died, while in the placebo group, 16 died.
At the end of the study month, 80 patients in the canakinumab group (35.2 percent) had no signs of infection — the same was true for 68 patients in the placebo group (30.4 percent). Similar numbers of both groups went home from the hospital.
The researchers concluded that this monoclonal antibody did not significantly improve patient survival.
Indeed, the researchers noted that a separate study of anakinra, a similar drug used to treat rheumatoid arthritis, was discontinued early because that study failed to produce significant results.
The researchers also looked at immune system markers and found similar results between the two patient groups
Why didn’t this study find that canakinumab helped Covid patients when other monoclonal antibodies received FDA approval?
It is possible that other treatments the patients received may have affected the results.
Each of the 39 hospitals involved had different treatment procedures for Covid, which changed over the course of the study.
In addition, experts from the National Institutes of Health recommend that if a patient receives monoclonal antibody treatment, it should begin as soon as that patient tests positive for Covid.
The patients in this study were already seriously ill — and the timing was not standardized across hospitals — so the treatment was less likely to have worked because it wasn’t started immediately.
In future research into monoclonal antibody treatments, more rigidly standardized studies may help researchers see conclusive results.