Kevzara puts another nail into Covid-19 “cytokine storm”

Kevzara’s second failure in Covid-19 could put to bed the cytokine storm theory in coronavirus infection – as far as the Sanofi/Regeneron drug is concerned, anyway. What it means for other IL-6-blocking antibodies is less clear. The most prominent of these, Roche’s rheumatoid arthritis drug Actemra, has already been added to Chinese emergency use guidelines, though the only data backing it have come from a small, academic, French study. Yesterday Sanofi and Regeneron said a phase II/III study of Kevzara plus standard of care in Covid-19 patients on ventilators had failed to yield an improvement versus standard of care alone. In April the same study had its less-severe hospitalised patient cohort scrapped after an interim analysis showed no benefit. The theory that surges in cytokines including IL-6 cause coronavirus patients to become severely ill is controversial (Making sense of Covid-19 treatment approaches, March 25, 2020). Apart from Sanofi/Regeneron’s two Kevzara trials, 13 other studies of the drug in Covid-19 are being run with academic sponsorship, according to clinicaltrials.gov. And Kevzara’s makers are not giving up yet, either: a separate trial in 2,500 severe Covid-19 subjects is continuing, and should read out in the third quarter.