Arthritis drug shows promise against severe Covid, study says

A repurposed arthritis drug has shown positive results in a clinical trial of patients hospitalised with Covid-19, according to a paper published Wednesday in the New England Journal of Medicine.

Tofacitinib, taken orally and sold under the brand name Xeljanz among others, was tested in a trial of 289 patients hospitalised with severe Covid across 15 locations in Brazil.

Half received the drug – a 10mg pill twice a day – and standard care like glucocorticoids that tamp down an overactive immune response, while the other half received a placebo and standard care.

After 28 days, 18.1% of the group receiving the tofacitinib progressed to respiratory failure or death, compared to 29% in the placebo group.

This represented a statistically significant relative risk reduction of 63%.

Respiratory failure refers to a patient requiring noninvasive ventilation through an oxygen mask, or being intubated and placed on a mechanical ventilator.

Deaths after 28 days occurred in 2.8% of patients in the tofacitinib group and in 5.5% of those in the placebo group.

Serious side effects occurred in 14.1% in the tofacitinib group and in 12% in the placebo group.

“We are encouraged by the initial findings of our randomised trial of tofacitinib in patients hospitalised with Covid-19 pneumonia,” said Otavio Berwanger of Hospital Israelita Albert Einstein, which coordinated the trial in collaboration with Pfizer.

“These results provide new information which indicates that the use of tofacitinib when added to standard of care, which includes glucocorticoids, may further reduce the risk of death or respiratory failure in this patient population.”

Tofacitinib belongs to a class of drugs called Janus kinase (JAK) inhibitors.

It is approved in the US to treat conditions including rheumatoid arthritis, psoriatic arthritis and ulcerative colitis.