Mortality among patients hospitalised with COVID-19 is reduced when they receive treatment with Interleukin-6 antagonists, according to the findings of a major analysis that has led to a change to global guidelines.
Professor Manu Shankar-Hari of King’s College London, UK, and colleagues studied trials of interleukin-6 antagonists. The trial results varied, reporting a potential clinical benefit, no benefit, or potential harm.
The researchers closely examined the 27 highest quality trials including 10,930 patients, comparing them with usual care or placebo and looking at 28-day all-cause mortality and other outcomes.
Overall, the risk of death was 14% lower on Interleukin-6 antagonists, corresponding to an absolute mortality risk of 22% with the drugs, versus 25% for usual care or placebo.
The study was published yesterday in the Journal of the American Medical Association.
Commenting on the results of the analysis, Dr Janet Diaz, lead for clinical management at the World Health Organisation emergencies section, said: “We have updated our clinical care treatment guidance to reflect this latest development. While science has delivered, we must now turn our attention to access. Given the extent of global vaccine inequity, people in the lowest income countries will be the ones most at risk of severe and critical COVID-19. Those are the people these drugs need to reach."
Professor Shankar-Hari said: “Our research shows that interleukin-6 antagonists reduce deaths from COVID-19, i.e. save lives and prevent progression to severe illness necessitating breathing support with a ventilator. Further, interleukin-6 antagonists appear even more effective when used alongside corticosteroids."
Claire Vale of University College London, UK, stated: “These results, which will lead to better outcomes for patients hospitalised with COVID-19, reflect a huge global effort. Bringing together this information in such a short space of time has only been possible thanks to the overwhelming commitment of all the doctors and teams who ran the trials, and of course, the patients who took part in them.”
Shankar-Hari, M. et al. Association between administration of interleukin-6 antagonists and mortality among hospitalized patients with COVID-19: a meta-analysis. JAMA 6 July 2021; doi: 10.1001/jama.2021.11330
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