WIREDGOV

The NHS is rolling out a cutting-edge, life-saving COVID treatment as of yesterday, which is proven to save lives when given to the most seriously ill COVID patients in hospital.

The RECOVERY trial carried out through the NHS found that 13% fewer severely ill patients died of COVID when treated with arthritis drug baricitinib compared to existing treatment options.

Typically used to treat arthritis to reduce pain and inflammation, baricitinib can now be given to hospitalised COVID patients in addition to current treatments, and clinical studies show that this can provide benefits on top of existing treatment.

It is the latest in an armoury of COVID treatments that the NHS has at its disposal, which now includes three repurposed arthritis drugs – with baricitinib joining tocilizumab and sarilumab – that have treated more than 32,000 of the most severely ill COVID patients in hospital.

The NHS has led the rollout of COVID medicines, from the discovery of dexamethasone as the world’s first effective treatment, to the first vaccination outside of a clinical trial in December 2020.

These arthritis drugs work by reducing inflammation caused by COVID-19 by blocking signals to the immune system that are causing it to attack the body.

Baricitinib bolsters the options at doctors disposal when looking to treat hospitalised patients in the most effective way and can be used to supplement other COVID treatments in patients aged two and over.

As well as these arthritis drugs, the NHS continues to use other monoclonal antibody and antiviral treatments, and combined these COVID medicines have been given to hundreds of thousands of patients, saving tens of thousands of lives.

Using existing drugs in different ways is part of the world-leading innovation that is being carried out by the NHS, in line with the Long Term Plan commitment to develop and implement cutting-edge treatments.

NHS Medical Director Professor Steve Powis yesterday said:

“The more effective COVID treatments within the NHS arsenal, the more options doctors have to help patients who become seriously ill with COVID, preventing hospital admissions and saving lives.

“This is the fourth drug that has been fast-tracked for use on the NHS thanks to the world-leading RECOVERY trial and is just as important because it gives our hard-working clinicians another life-saving treatment option and strengthens our defence against COVID-19.

“Finding ways to beat COVID has showcased the very best of the NHS’s power to find creative and innovative ways to care for patients and implement new treatments, which includes in this case successfully repurposing an existing drug to treat a deadly virus.”

The agreement to offer baricitinib to treat COVID patients in hospital follows that of similar drugs, tocilizumab and sarilumab, which are also routinely used for rheumatoid arthritis and other inflammatory conditions.

It will be the seventh COVID treatment approved in total for use on the NHS, and will be used to treat hospitalised patients in line with MHRA guidance.

Health and Social Care Secretary Sajid Javid yesterday said:

“It is fantastic that NHS patients are now able to access this highly effective treatment for COVID. Our world-leading national effort to identify new drugs to treat this virus continues as we add this game-changing medicine, baricitinib, to our arsenal.

“As we live with the virus, having access to a growing number of treatments – alongside our lifesaving vaccination programme – is absolutely vital.”

The RECOVERY trial, conducted by the NHS and University of Oxford, found that among the more than 8,000 severely ill participants – half of whom were given the drug – that there was a 13% reduction in deaths.

These benefits were felt even among patients who were also taking other COVID treatments, including corticosteroids, tocilizumab, or remdesivir, further increasing survival rates, although these will vary on an individual basis.

Patients given baricitinib will receive a daily dose for 10 days, or until they are discharged from hospital, whichever comes first.

Case study

Mark Rivvers, 51, deputy head porter at Fitzwilliam College, University of Cambridge, took part in the baricitinib study in the RECOVERY trial when he was admitted to Addenbrooke’s Hospital with severe COVID-19 toward the end of last year.

He yesterday said:

“I feel privileged to have been part of the RECOVERY trial, and I am extremely happy with this new announcement. It’s great to think that baricitinib could potentially benefit many more people severely ill with COVID-19 as I was.

I’ve got nothing but praise for the treatment I received from the ICU team at Addenbrookes Hospital, who excelled themselves every day. I will never be able to properly pay them back for their dedication, but taking part in the trial was something positive I could do. I’m really glad the results are now being used to help others.”

Sir Martin Landray, Professor of Medicine and Epidemiology at Oxford Population Health, and Joint Chief Investigator for RECOVERY, yesterday said:

“We’re delighted that the RECOVERY trial has identified another treatment for patients hospitalised with COVID-19.

“Baricitinib works in addition to other proven therapies (such as dexamethasone). Although we have effective vaccines and treatments, hospitalisation with COVID-19 is still associated with poor outcomes so it’s vital that we continue to use randomised trials to identify new therapies that can reduce risk further.”

Baricitnib is the fourth treatment that the RECOVERY trial has shown to save lives, following the steroid dexamethasone the arthritis treatment tocilizumab, and a combination of monoclonal antibodies (casirivimab plus imdevimab) targeting the viral spike protein, known as Ronapreve.

The drug adds to the NHS arsenal to beat COVID, which also includes the fastest and largest vaccination programme in health service history, with more than 122 million doses delivered.

While it will still be up to clinicians to decide on a case-by-case basis whether this treatment, another COVID medicine, or a combination, is the best choice for their patients, this latest drug is an important step in the NHS fight against the virus.