Tocilizumab, arthritis medicine used to treat Covid-19

Today it was revealed that, after the shortage complaint, the management of the Ministry of Health and the Federal Commission for the Protection against Sanitary Risks (Cofepris) the drug Tocilizumab was approved for immediate import.

This medicine used to treat rheumatoid arthritis has worked for the time being as an alternative to treat seriously ill patients with Covid-19, but what do these diseases have in common that makes this medicine be considered an alternative?

The doctor of biomedical sciences, Omar Francisco Carrasco Ortega In an interview with EL UNIVERSAL, he clarified that Tocilizumab is a medicine that has the function of modulating the response of “interleukin-6”, which is an antibody, in charge of mediating the process that the immune response faces in the cells that fight in against infections and foreign agents that can attack the stability of the organism.

The idea of ​​using Tocilizumab, according to the statements of the surgeon, was originally thought for diseases where there is an altered immune response, such as rheumatoid arthritis (RA), in which patients have an immune hyperresponse, which many times, it can be more harmful than beneficial in the face of infection, “which means an overexpression of molecules and cells that intensifies the symptoms of the disease, so the medicine reduces the pain in the joints,” said the expert.

The graduate of the Faculty of Medicine (FM) of the National Autonomous University of Mexico (UNAM) explained that this drug is of a biological type, the synthesis that it undergoes to obtain a drug, is produced through a cell of the being alive. He also determined that this treatment is delivered parenterally, that is, through intravenous therapy, because if it were to be ingested orally, these proteins, when in contact with the human body, could break stomach walls.

Carrasco Ortega pointed out that this medicine has been chosen only in the face of more serious manifestations in which Covid-19 precipitates coagulation disorders. “It is in this scenario, where there are the worst outcomes, since the immune response is exaggerated, which causes many inflammatory mediators to begin to be released, which, far from helping to counteract the infection, inflame and damage tissues such as the vascular endothelium (which is inside the blood vessels); Tocilizumab favors that the immune response is less and the inflammatory process is not so severe. “

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The member of the Center for Research in Policy, Population and Health (CIPPS) explained that the similarities between rheumatoid arthritis and the new coronavirus have to do with the fact that both manifest an exaggerated symptomatic response and a demodulation of the immune system, which attacks to the body’s own cells, so Tocilizumab serves as an efficient regulator against these expressions.

On the other hand, the UNAM professor warned that, as in all the drugs that are being evaluated, there is very little evidence of their effects, so constant research is needed for their possible use. “There is a marker known as” C-reactive protein “, (which increases inflammatory levels) when it is very high, we can assume that it is subtle to administer,” however, he recalled that it must be injected in very small and limited series. “

The purchase and sale of Tocilizumab does not require a prescription, “in fact, you can go to the pharmacy, ask for Tocilizumab, which costs around 8 to 9 thousand pesos, and sell it to you, as a step with chloroquine and hydroxychloroquine, when they are mentioned in the media, people go and buy them, causing the shortage ”. Therefore, the member of the Cofepris Joint Advisory Council from Health Secretary reflected that “no drug is completely safe, the safety profile of all drugs, whether it is an aspirin or one of these monoclonal antibodies have specific indications and dosages, so there can be adverse reactions.”

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“Adverse reactions, related to the mechanism of action of the drug, cause the immune system to become depressed; the first logical adverse reaction will be the appearance of infections, specifically in upper airway infections, increased cholesterol production and gastrointestinal perforation, therefore it may favor infection, therefore the use of Tocilizumab is being limited only for selected cases or very strict, because it can increase the risk of respiratory diseases, “he explained and determined that the sectors most susceptible to superinfection are people over 65, patients with diabetes or who already had a previous infection.

Given the concern that people with rheumatoid arthritis and who need this medicine, which is already in short supply, stated that Tocilizumab is not the only inhibitor to combat the reactions of this disease, but that there are many other medicines for the disinflammation of joints, such as “Anakinra”, “Adalimumab”, “Infliximab”, “Rituximab”, “Abatacep”.

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“One of the most trained doctors in the field of immunology is the rheumatologist, the doctors of this branch, know perfectly well that if any of these remedies is missing, they have many other therapeutic options that they can implement for the correct care and maintenance of the symptoms. of these autoimmune diseases ”, reported the professor in pharmacology.

He recalled that “there is still no clear guideline for the use of Tocilizumab for the treatment of Covid-19, there are other drugs that act in the same way, and that they are being evaluated and it is understandable, we do not have any approved treatment, we have to use what we have at hand, “he also added that people have to go to a doctor first,” before having contact or trying to administer with the medicines read, not only in this note, but on television and media: No to self-medication. Everything must be done through medical authorization. ”

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