THE TOCILIZUMAB IN THE DAYS OF COVID 19
Author: Antonia Mele
AIFA a few days ago gave the go-ahead for the Tocilizumab trial to treat pneumonia induced by the new Coronavirus infection.
Patients over 18 years of age with confirmed Covid 19 infection will be chosen for this study; however, patients in whom, according to the treating physician’s opinion, progression to death is imminent and inevitable within 24 hours, regardless of the treatment provided, patients with active tuberculosis (TB) or with suspected bacterial, fungal, viral or other active infection (in addition to COVID-19) are excluded. It is expected that the total duration of the study, from screening of the first patient to the end of the study, will be approximately 10 months.
The Pascale Hospital in Naples was the first to test this drug on Covid19 patients.
But what is Tocilizumab and how does it work?
Tocilizumab is a monoclinal antibody directed against both forms of the IL-6 receptor (a protein released to stimulate an immune response), i.e. the one expressed on the cell membrane and the circulating soluble one.
It is administered by intravenous infusion every four weeks.
Clinical studies have shown that age, sex and race do not influence its pharmacokinetics.
It is frequently associated with methotrexate at a dose of 8 mg|kg for moderately severe active rheumatoid arthritis in patients who do not respond to other therapies, including those with monoclonal antibodies against TNFa.
However, there are many side effects associated with the use of Tocilizumab.
In fact this drug can cause upper respiratory tract infections, hypertension, mild increase in ALT and AST (transaminases) and increased plasma levels of total cholesterol and triglycerides. There may be more serious effects such as fatal infections, gastrointestinal perforations and anaphylactic shock. As with all monoclonal antibodies, Tocilizumab can also increase the risk of malignant formations.
Remember that it is not a medicine commonly used by all Covid 19 positive patients, but it is only used in hospitals, especially in patients with advanced pulmonary inflammation.
I would like to conclude by thanking Roche, a pharmaceutical company that undertakes to provide Tocilizumab free of charge for the period of the emergency, to all Regions that request it, except for the stocks necessary to allow therapeutic continuity to patients suffering from diseases for which the product is authorized.