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East of England people help world’s largest COVID-19 trial make another big breakthrough

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The world’s largest COVID-19 treatment trial has found that baricitinib, an anti-inflammatory rheumatoid arthritis drug, reduces deaths in patients hospitalised for COVID-19 by around one-fifth.

The RECOVERY Trial, funded by the NIHR, has been investigating treatments for people hospitalised with COVID-19 since March 2020. Every acute NHS hospital in the East of England has recruited participants to the study with 3449 people in the region taking part so far.

Nationally, between February and December 2021, 4,008 patients randomly allocated to usual care alone were compared with 4,148 patients who were randomly allocated to usual care plus baricitinib.

The dose of baricitinib was a 4mg tablet once daily for 10 days (or until discharge from hospital if sooner). Treatment with baricitinib significantly reduced deaths, with a reduction of 33 deaths compared to patients within the usual care group - from 546 to 513.

The benefit of baricitinib was consistent regardless of which other COVID-19 treatments the patients were also receiving, including corticosteroids, tocilizumab, or remdesivir.

Patients receiving baricitinib were also more likely to be discharged alive within 28 days. Among patients not on invasive mechanical ventilation when entered into the trial, baricitinib reduced the chance of progressing to invasive mechanical ventilation or death from 17% to 16%.

The RECOVERY trial has recruited over 47,000 participants nationwide and is now considered the world’s largest clinical trial for COVID-19 treatments. To find out more, visit the RECOVERY trial website.

Since starting, the study has also discovered that dexamethasone, a steroid used to treat a wide range of health conditions, can help reduce deaths by one third among the sickest patients and that tocilizumab, an immunosuppressive drug, can further reduce the risk of death from severe COVID-19.

Dr Helen Macdonald, Chief Operating Officer for the NIHR Clinical Research Network East of England, said:

"We welcome the news of this latest breakthrough thanks to this vital research, carried out with immense dedication by our research teams alongside their multidisciplinary colleagues. Research breakthroughs such as this are not possible without the patients and their loved ones who volunteer to help. We are enormously grateful to every single person involved in the RECOVERY trial.”

Baricitnib is the fourth treatment the RECOVERY trial has shown to save lives, following the steroid dexamethasone, the arthritis treatment tocilizumab, and a combination of monoclonal antibodies targeting the viral spike protein, known as Ronapreve. These discoveries have changed clinical practice worldwide and been credited with saving hundreds of thousands, if not millions, of lives.