The World Health Organization (WHO) has updated its patient care guidelines to include interleukin-6 receptor blockers, a class of medicines largely used to treat rheumatoid arthritis pre-pandemic, but which are now considered lifesaving in patients who are severely or critically ill with Covid-19.

The guidelines were updated after the WHO carried out a prospective and living network meta-analysis involving data from over 10,000 patients enrolled in 27 clinical trials. This is the largest such analysis carried out on these drugs to date.

Patients who are severely or critically ill with Covid-19 often suffer from an overreaction of the immune system, which can be very harmful to their health. Interleukin-6 blocking drugs – tocilizumab and sarilumab – act to suppress this overreaction. 

The meta-analysis showed that in severely or critically ill patients, administering these drugs reduced the odds of death by 13%, compared to standard care. This translates to 15 fewer deaths per 1,000 patients, and as many as 28 fewer deaths for every 1,000 critically ill patients.

Furthermore, the odds of mechanical ventilation among severe and critical patients are reduced by 28%, compared with standard care. This translates to 23 fewer patients per 1,000 needing mechanical ventilation.

These are the first drugs found to be effective against Covid-19 since corticosteroids were recommended by the WHO in September 2020.

As part of this research, clinical trial investigators in 28 countries shared data with the WHO, and researchers worldwide compiled and analysed this data. The WHO said as a result of these “critical partnerships”, it has been able to issue “a rapid and trustworthy recommendation” for the use of interleukin-6 receptor blockers in severe and critical COVID patients.

“These drugs offer hope for patients and families who are suffering from the devastating impact of severe and critical Covid-19, but interleukin-6 receptor blockers remain inaccessible and unaffordable for the majority of the world.

“The inequitable distribution of vaccines means that people in low and middle-income countries are most susceptible to severe forms of Covid-19. So, the greatest need for these drugs is in countries that currently have the least access. We must urgently change this,” commented WHO director general, Dr Tedros Adhanom Ghebreyesus.

In order to increase access and affordability of these life-saving products, the WHO is calling on manufacturers to reduce prices and make supplies available to low and middle-income countries, especially where Covid-19 is surging.

The updated patient care guidelines can be viewed here.