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In fact I have an email this morning inviting me to the webinar with NHSEI to ‘discuss recent trial results for use of the IL6-R mab (Tocilizumab) in Critical Care for Covid-19 Patients’ at 16:00 today!
Trial results tomorrow maybe
In a few days or so the final results of the Tocilizumab arm of REMAP-cap are coming out and I strongly suspect they’re going to show that a mab against the IL6 receptor is currently THE best drug the world has at treating people with severe COVID.
From The Tils website
Expediting cGMP manufacturing of anti-IL-6 receptor (anti-IL-6R) monoclonal antibodies, and developing a handheld inhalation technology for direct delivery to the lungs to treat COVID-19 infections.
They need to be upping the PR here before those results come out
and provided no additional benefit to critically ill COVID- 19 patients, compared to those who did not receive the drug. The analysis found an estimated odds-ratio of 0.67 (worse than control) with a 99.9 per cent probability of futility (an odds ratio less than 1.20).
REMAP-CAP began investigating treatments for COVID-19 in March 2020, enrolling hospitalised patients with either moderate or severe (requiring ICU care) COVID-19 disease.
The study design randomises patients to multiple combinations of treatments, enabling researchers to evaluate different treatments for COVID-19, including antivirals, drugs which modulate the immune response, and therapies that modulate or support other vital aspects of the body's response to the virus.
In total, over 2,000 patients in 15 countries have been enrolled at more than 260 hospitals worldwide and randomised to multiple treatment combinations. The effects of interventions are assessed separately for moderate and severely ill patients.
The latest findings on tocilizumab and lopinavir/ritonavir add to REMAP-CAP findings from earlier this year, which found that hydrocortisone steroid treatment improved recovery among critically ill COVID-19 patients.
“This is an absolutely amazing result,” said Dr Lennie Derde, Consultant in Intensive Care Medicine at the University Medical Center in Utrecht and the Immune Modulation Domain Specific Working Group Chair. “To have a second effective therapy for critically ill patients within months of the start of the pandemic is unprecedented. Specific targeting of the immune response is theoretically attractive, and now we have shown it works.”
The study is supported in the UK by the National Institute for Health Research (NIHR) and Imperial College London & ICNARC are partners in the EU funded PREPARE consortium.
IMPERIAL COLLEGE LONDON PRESS RELEASE
FOR IMMEDIATE RELEASE: Thursday 19 November 2020
Arthritis drug effective in treating sickest COVID-19 patients
Critically ill patients with COVID-19 treated with an arthritis drug that reduces inflammation are significantly more likely to have improved outcomes, an international study has found.
The early findings, which are yet to be published, come from the REMAP-CAP trial, led by Imperial College London and the Intensive Care National Audit & Research Centre (ICNARC) in the UK and Utrecht University in Europe. The trial evaluates the effect of treatments on a combination of survival and length of time patients need support in an intensive care unit (ICU).
The results show that treatment with tocilizumab, an immunosuppressive drug used to treat rheumatoid arthritis, reached a key efficacy endpoint among critically ill patients with severe COVID-19, compared to patients who did not receive any immune modulation treatment.
Patients receiving tocilizumab were more likely to improve (measured by a combination
of organ support, such as a breathing machine, in the ICU and surviving the hospital admission) compared to patients who received no immune modulator. The relative contribution of survival and reduced length of time needing organ support in ICU has not yet been analysed. The trial does not yet know the relative benefits of tocilizumab compared to the other immune modulators. Further data are expected in the coming weeks and months.
Due to the clinical implications for patients, the researchers have released the findings before they have been peer-reviewed, but are working to analyse and publish the full results as soon as possible.
Professor Anthony Gordon, Chair in Anaesthesia and Critical Care at Imperial College London and a Consultant in Intensive Care Medicine at Imperial College Healthcare NHS Trust, said: “These early findings show that treatment with this immune modulating drug is effective for critically ill COVID-19 patients in intensive care units. When we have the results available from all participants, we hope our findings will offer clear guidance to clinicians for improving the outcomes of the sickest COVID-19 patients.”
The latest analysis was carried out by a Statistical Analysis Committee separate from the trial investigators and reviewed by an independent Data and Safety Monitoring Board (DSMB) on 17th November. The analysis included data from the first 303 patients randomised to receive immune modulation treatments: tocilizumab, sarilumab, anakinra, interferon, or no immune modulator.
The trial data yielded an estimated odds ratio of 1.87 for a better outcome with tocilizumab compared to no immune modulation, with a high degree of statistical certainty (99.75% probability that tocilizumab is superior to no immune modulation).
In addition to these findings, the latest analysis also revealed an antiviral drug called Kaletra (lopinavir/ritonavir) to be ineffective and provi
I don’t think people realise just how important this is. Up until yesterday I only had one drug which could be used to ‘treat’ these people. Now it looks like we have two. The trial was stopped after 303 patients were randomised due to the treatment arm being statistically superior, making it unethical to continue NOT to give it to patients. That means the positive effect must be big, way bigger than Dex with its NNT of 36. I want to start giving this to my desperately sick patients on the unit today. Not bothered about inhalational delivery because we’re taking ICU here I.e. ventilated patients. In fact I’d rather it be IV. Tils need to start banging this stuff out now because every intensivist in the world this morning is going to work and asking their pharmacy division to go buy this. I know I am!
‘These early findings show that treatment with this immune modulating drug is effective for critically ill COVID-19 patients in intensive care units.’
Part of REMAP-CAP. Same trial that found dex worked. Big news
BMO3 with all due respect that will it be the case. Ideally the BOD and those involved in the trial will be blinded to as to which patients are receiving either treatment. I’ve not seen the study protocol so I don’t know the methodology but to think any ideas as to the outcome of the trial would be know at this stage is false. If you consider that even the ‘brilliant’ dexamthasone still has a number needed to treat of 36 to (1 extra life saved for every 36 given the drug), well need a fair amount of data before we can say whether or not this is effective. There are numerous studies where the labs/vitals/whatever appear to improve with the intervention but this is not translated into a positive primary outcome.
Let’s hope you’re right mate. The more I see of this murky share world, the less inclined I am to think of it as ‘investing’. It seems companies can go from concepts to profit making and the only thing that goes up is the CEOs bonus. PI take the risk, the directors take the ****.
Not specifically aimed at tils, just a general rant fuelled by my inability to take profits or sell duffers
The sp is currently providing the answer to the many who questioned the sellers at 150-170 before receiving their currently valueless accustem shares
Totes. I heard accustem is going to list for a fiver so tils had to drop to prevent us all being too minted
On my ICU we’ve stopped using remdesivir outside of clinical trials, as have most Trusts around us. It will be shown as being completely ineffective I guarantee it. This is clearly an immunologically driven disease and we getting suggestions through the scientific community to increase the dose of dex higher than current levels we’re using. I doubt a vaccine will ever be found that’s effective (see mutations coming out of Denmark already).
It’s an immunological disease which will require immuno-modulating treatment
Ha! Good job this isnt my day job. Give up trying to understand this carp. See you next week!
Let’s hope for a mega RNS tomorrow or gonna see a load of selling IMHO. Though as the rise up hasn’t been as high as we thought maybe the sell off will be less too. Maybe
This rise up to the demerger reminds me of a time when I was seeing a bird who I really didn’t fancy.
Limp and difficult to sustain
@oldapache, don’t get me wrong I think the stuff in the pipeline looks great and should power tils post demerger way above 3 quid in the future. Perhaps I should’ve clarified that that is only my immediate, short term view of how things will pan out. Any covid news positives RNS could, as I’ve said previously, seen it to the moon. But without news I think we see a significant drop post split. Of course I may be totally crazy, and I am useless at predicting the market, and are very good at buying spikes. So good advice would be to ignore the drivel I spout. Maybe do the opposite
Vbw
Anyone who thinks there won’t be a drop in tils after we collected our accustem shares is, imho, bat sheet crazy.
This argument that the market isn’t attributing any value to stem is bonkers, as many of us are loading up now to ensure we onboard before the split. I don’t think Rubbishes’ prediction of 50% will necessarily be far off. 1.50 for tils alone, 1.50 for stem, 3 quid before the split. Job done.
McLovin it!
So far
What u on about the owners of dex? It’s generic, manufactured by about a dozen companies
Well you certainly timed your exit and re-entry a lot better than me! Kudos and welcome back
If the Brazil trial shows positive results, especially in the Formulab only arm, then the Sp will be somewhere in the zillion pound range IMHO