Should I take tocilizumab and sarilumab to treat COVD-19?

You might have been reading about ivermectin in the news as a possible treatment for COVID-19. Now, two more drugs—tocilizumab and sarilumab—have joined the mix. 

Below, we answer some questions about these two drugs and their potential role in the pandemic. 

What are tocilizumab and sarilumab? 

Both tocilizumab (brand name Actembra) and sarilumab (brand name Kevzara) are prescription medications used to treat rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disease in which your body’s immune system attacks its own system, affecting your joints as well as a variety of other body systems.

Sarilumab received FDA approval in 2017, while tocilizumab was approved in 2010. They are both solutions that must be injected into the body. This means you likely won’t see this being picked up at a traditional pharmacy. Common side effects can include headache, runny nose, and swelling or pain at the injection site. 

How might tocilizumab and sarilumab help fight COVID-19? 

Both tocilizumab and sarilumab belong to a class of drugs known as IL-6 receptor antagonists, and they work by reducing the effects of proteins often responsible for an over-reactive immune system. This has potential as a treatment for COVID-19 because severe cases of the virus can involve dangerous levels of inflammation in the body. Therefore, tocilizumab and sarilumab might be able to reduce the severity and risk of this inflammatory response. 

What studies have been done on COVID-19 and tocilizumab and sarilumab? 

The latest results come from a clinical trial involving 3,900 COVID-19 patients from 15 different countries. The drugs reduced the risk of death in 729 patients who received one of these two drugs within 24 hours of being put on organ support in intensive care. Specifically, there was a 24% relative reduction in risk of death when compared to the group of patients who received standard care (i.e. did not receive tocilizumab or sarilumab). These patients also recovered more quickly, leaving intensive care about 7 to10 days earlier

While these results are promising, it is important to note that this study has not yet been peer-reviewed, and the study only focused on critically ill patients. Additionally, most of the patients in the study were also taking steroids like dexamethasone, which might mean these two drugs are most beneficial when used in conjunction with others. 

Should I take tocilizumab and sarilumab?

At this point, no. Until more studies are done, these drugs are only being administered in a clinical study setting as a treatment for COVID-19. Additionally, both drugs are only being used in severe cases where patients with COVID-19 have been checked into the ICU. They are not taken preventatively

As always, you should never take a new drug or change your medical routine without consulting with your doctor. If you have more questions about these two drugs, you should ask your physician or a pharmacist. 

How much do tocilizumab and sarilumab cost?

Unfortunately, both of these drugs are significantly more expensive than other drugs that have been investigated as a treatment for COVID-19. This is because both are relatively new drugs that do not have generic equivalents. Tocilizumab costs around $491, and sarilumab costs around $3, 642 depending on the dose. 

Ivermectin, by contrast, costs $80. If you’re curious about other medications being investigated as COVID-19 treatments such as ivermectin, you can read our blog posts on the topic here and here.

Jessica Nouhavandi