The World Health Organization (WHO) has added “life-saving” interleukin-6 receptor blockers to its list of treatments for COVID-19 – only the second drugs recommended as effective against disease – as the pandemic continues to accelerate across the world.
The WHO said the drugs worked particularly well when used with corticosteroids, which were recommended by the WHO in September 2020.
“These drugs offer hope to patients and families suffering from the devastating impact of severe and critical COVID-19,” WHO Director-General Tedros Adhanom Ghebreyesus said in a statement.
Patients with severe cases of COVID-19 often suffer from an overreaction of the immune system, and the interleukin-6 blocking drugs – tocilizumab and sarilumab – work to suppress the overreaction.
The WHO said trials have shown that in critically ill patients, administering the drugs resulted in 15 fewer deaths per 1,000 patients. For critically ill people, the use of interleukin-6 has resulted in up to 28 fewer deaths per 1,000 patients. The drugs also meant that the risk of critically ill and critically ill patients being put on a ventilator was reduced by 28%, compared to standard care.
The recommendation comes as countries around the world, including South Africa, Indonesia and Bangladesh, battle new devastating waves of the virus fueled by the Delta variant that first emerged in India. An effort is already underway at the World Trade Organization to remove patent protections on COVID-19 vaccines to improve access for the poorest countries, and calls are being made to remove barriers to the intellectual property rights for drugs essential for the effective treatment of serious coronaviruses.
Tocilizumab belongs to a class of drugs called monoclonal antibodies (mAbs) used in the treatment of various diseases, including arthritis and cancer, and is manufactured by the Swiss pharmaceutical giant Roche. It sells the drug under the brand name Actemra.
Following the WHO recommendation, Médecins sans frontières (known by its French initials, MSF) urged Roche to lower the price of the drug to make it affordable and accessible, and to share know-how, master cell lines and technology to allow other manufacturers around the world to make the drug, too.
“This drug could become essential for treating people with critical and severe cases of COVID-19 and reducing the need for ventilators and medical oxygen which are scarce resources in many places,” said Julien Potet, policy adviser on neglected tropical diseases in MSF’s access campaign. in a report. “Roche must stop taking a business-as-usual approach and take urgent action to make this drug accessible and affordable to all who need it by reducing the price and transferring technology, know-how and cell lines to d ‘other manufacturers. Too many lives are at stake.
Most of the existing mAbs are expensive, making them inaccessible to low- and middle-income countries.
MSF said that although tocilizumab has been on the market since 2009, the price has remained very high in most countries – from $ 410 in Australia to $ 646 in India and $ 3,625 in the United States for a dose of 600 mg for COVID-19. The cost of making tocilizumab is estimated at just $ 40 per 400 mg dose, he added.
Sarilumab, the second mAb recommended by the WHO, is manufactured by the US pharmaceutical company Regeneron and the French drug maker Sanofi, which market the product under the Kevzara brand. Regeneron has filed for and obtained patents on sarilumab and its formulation in at least 50 low- and middle-income countries, according to MSF.
The WHO has also called on manufacturers to reduce the price of drugs, accept transparent and non-exclusive licensing agreements or give up exclusive rights.
“IL-6 receptor blockers remain inaccessible and unaffordable for the majority of the world,” Ghebreyesus said.
“The inequitable distribution of vaccines means people in low- and middle-income countries are most susceptible to severe forms of COVID-19. Thus, the greatest need for these drugs is found in the countries which currently have the least access to them. We urgently need to change this. “
The recommendation follows analysis of data from more than 10,000 patients involved in 27 clinical trials.