Two Arthritis Drugs Show Different Benefits for Coronavirus

Conflicting trial results on Monday dealt a blow to the idea of using rheumatoid arthritis medicines for a broad group of coronavirus patients.

One clinical trial, from Sanofi and Regeneron Pharmaceuticals Inc., suggested that arthritis medicine Kevzara might help only people who were critically ill -- prompting the companies to push forward with a bigger study focused on the most dire cases. A smaller trial of a similar drug, Roche Holding AG’s Actemra, showed a potential benefit in a broader group, though the results haven’t been published in full.

The arthritis-drug effort is one of many programs to evaluate known treatments -- from antiviral drugs to plasma from recovered patients -- against Covid-19 in stringent clinical tests as the number of infections globally nears 3 million.

Unlike antivirals, arthritis drugs won’t attack the virus directly, but instead are thought to have an effect on the immune system’s response to the pathogen. The idea is to prevent the massive immune reaction -- the “cytokine storm” -- that chokes the lungs of the sickest patients.

The research on Actemra could point to an advantage, though “data from larger trials are needed to prove the efficacy of both drugs,” Sam Fazeli and Cinney Zhang, analysts for Bloomberg Intelligence, wrote in a note.

The Sanofi and Regeneron trial did show that Kevzara lowered a key measure of inflammation. Patients who took the drug had lower levels of c-reactive protein, an inflammation signal, than those given a placebo in an intermediate study, the companies said Monday. The medicine only helped the most severely ill group of people, though, leading to the decision about who to enlist in the next stage of research.

Meanwhile, Roche’s Actemra did seem to help less seriously ill patients in a smaller 129-person study, researchers at Assistance Publique - Hopitaux de Paris said on Monday. Patients who were hospitalized for moderate or severe pneumonia -- but weren’t sick enough for intensive care -- were less likely to die or need to be put on a ventilator when they took the drug, the study showed.

”This is very important,” said Olivier Hermine, a professor at Necker Hospital in Paris and the study’s coordinating investigator. “We have reduced significantly the transfer of patients from classical wards to intensive care units.”

Just how much Actemra could have helped is unclear, however, because the results weren’t disclosed in detail and haven’t yet been reviewed by outside scientists. The results need to be confirmed independently by additional studies, the research team said.

A big late-stage trial for Kevzara has already enlisted more than 600 patients who require treatment in an intensive-care unit, and the companies said they expect to report results by June. Sanofi Chief Executive Officer Paul Hudson last week described the tests as a “long shot.”

To contact the reporters on this story:
James Paton in London at jpaton4@bloomberg.net;
Naomi Kresge in Berlin at nkresge@bloomberg.net

To contact the editor responsible for this story:
Eric Pfanner at epfanner1@bloomberg.net

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