Roche’s Actemra a possible candidate for severe COVID-19 treatment

Roche’s Actemra (tocilizumab) generated $687m in the first quarter of 2020, a 30% increase compared to the same period in 2019, due to evidence of effective treatment in severe COVID-19 patients experiencing respiratory failure. However, Actemra’s Q1 sales increase may be a one-off occurrence as Kevzara fell short in its Phase II trial, says GlobalData, a leading data and analytics company.

Antoine Grey, Senior Healthcare Analyst at GlobalData, comments: “Actemra’s jump in sales may be based on the results of several Chinese cohort studies examining the immunological response to SARS-CoV-2 in patients diagnosed with COVID-19. March 2020 saw China’s National Health Commission adding Actemra to its COVID-19 guidelines for the treatment of lung inflammation in severe COVID-19 patients, with reports of effective treatment also coming from Italy.”

The use of Actemra was considered after the immunological profile of critically ill COVID-19 patients demonstrated hyperactivation of the humoral immune pathway, which includes IL-6, as a contributor to the development of acute respiratory distress syndrome (ARDS). As severe COVID-19 disease progression can lead to cytokine release syndrome (CRS), the dysregulation of the host immune response presents an important therapeutic target in tackling the disease. However, it is not yet clear if IL-6 is merely a biomarker or if it represents a central pathogenic element of severe COVID-19 that can be investigated as an avenue of therapeutic intervention.

Grey continues: “Recent studies from Germany have shown that even moderately elevated IL-6 levels above 80pg/mL can be used to identify patients at high risk of respiratory failure.”

Despite these promising initial results, the future of Roche’s Actemra in COVID-19 is not certain, with Sanofi and Regeneron’s two-part Phase II/III study of Kevzara (sarilumab), another rheumatoid arthritis medication, providing disappointing Phase II results. The difference in this trial, compared to the Chinese cohort, was that a placebo arm was included and showed no significant difference between Kevzara and placebo.

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