Roche’s Actemra, first approved by the US FDA in 2010 for rheumatoid arthritis, was approved to treat coronavirus patients with serious disease and lung damage, according to new China guidelines for COVID-19 treatment. Actemra isn't intended to kill the coronavirus directly. Instead, it inhibits the interleukin 6 (IL-6) receptor, a proinflammatory cytokine, reducing the potentially lethal cytokine storm that affects seriously ill patients. In the 2003 SARS outbreak, a similar lung inflammation occured in patients. China will allow the use of Actemra in patients with elevated IL-6 levels, which was already being used as an indicator of worsening disease.

The new coronavirus is now called SARS-CoV-2, emphasizing its similarity to the SARS virus. Roche has donated $2 million of Actemra to China, to help patients suffering from serious disease.

According to Roche, a scientist at the Chinese Academy of Sciences said at a government press conference that promising results had been observed in 14 serious and critically ill patients treated with existing meds—including for arthritis—at a hospital affiliated with the University of Science and Technology of China (USTC). USTC scientists have begun a parallel trial that will enroll 188 patients, half of them randomized to receive Actemra.

USTC scientists have identified IL-6 as a main culprit in the immune overreaction among COVID-19 patients. In 2017, the US FDA also OK'd Actemra to treat cytokine release syndrome—another cytokine storm—caused by CAR-T treatment.

In 2019, Actemra revenues were $2.4 billion, ranking sixth among Roche’s top-selling drugs. Sanofi and Regeneron are also investigating the use of Kevzara, an FDA-approved anti-IL-6 receptor therapy for rheumatoid arthritis, to treat COVID-19.

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Disclosure: none.