Outcomes of Hospitalized COVID-19 Patients Improve With Interleukin-6 Antagonists

Patients receiving both IL-6 and corticosteroids showed lower risks of death and mechanical ventilation.

A recent meta-analysis conducted by investigators from Kings College London, in collaboration with the University of Bristol and Guy's and St Thomas' NHS Foundation Trust, has discovered that interleukin-6 antagonists reduced the risk of death and the need for mechanical ventilation in hospitalized patients with COVID-19.

Results from the meta-analysis were published in the Journal of the American Medical Association.

"COVID-19 is a serious illness. 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,” Manu Shankar-Hari, critical care consultant at Guy's and St Thomas' Hospital NHS Foundation Trust said. “Further, interleukin-6 antagonists appear even more effective when used alongside corticosteroids. Our research findings reflect the incredible research effort from scientists worldwide since the start of the pandemic.”

For the meta-analysis, the team of investigators analyzed 27 randomized trials that included 10,930 participants. The trials were identified through systematic searches of electronic databases between October 2020 and January 2021.

Trials were eligible if they randomly assigned patients hospitalized for COVID-19 to a group in whom IL-6 antagonists were administered and to a group in whom neither IL-6 antagonists nor any other immunomodulators except corticosteroids were administered.

Findings showed that the risk of dying within 28 days for those patients who received IL-6 antagonists was 22%, compared to 25% in those receiving usual care. In patients who also received corticosteroids, the risk of dying within 28 days was 21%.

Additionally, patients who received both IL-6 antagonists and corticosteroids were found to have a 26% risk of progression to mechanical ventilation, compared to 33% in those receiving usual care.

"Bringing together the results of trials conducted around the world is one of the best ways to find treatments that will help more people survive COVID-19. We have updated our clinical care treatment guidance to reflect this latest development,” Janet Diaz, lead for clinical management at the WHO Health Emergencies said. “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."