Boise is one of a few cities where COVID patients can opt for this new treatment
There may not be a coronavirus vaccine in the near future for Idaho, as the number of people infected with COVID-19 climbs by hundreds each day.
But there are more options now for treating the disease than there were during Idaho’s spring surge of COVID-19. And at least two clinical trials are underway in Boise, giving patients access to medication that may prove effective in reducing hospitalizations and deaths from the coronavirus.
The St. Luke’s Downtown Boise hospital is starting to enroll patients in studies of tocilizumab, a human monoclonal antibody also known by brand name Actemra. The medication is typically used for rheumatoid arthritis and helps to suppress the body’s immune response. The studies officially began in May and June. One will end July 31, and the other in October, with a total of more than 800 patients expected to participate from several U.S. states and a handful of countries.
Some of the most severe cases of COVID-19 are believed to stem from an out-of-control immune response — a “cytokine storm” — when a person’s immune system overreacts to the new pathogen and, in the process, wreaks havoc on their vital organs.
The medication St. Luke’s will offer to patients as part of the clinical trials can target what researchers believe could be a key piece of that out-of-control immune response.
One of the clinical trials at St. Luke’s will study the use of tocilizumab along with the drug remdesivir, compared with remdesivir and a placebo. Another trial will study the use of the current best standard for treatment, combined with either tocilizumab or a placebo.
St. Luke’s trial researchers don’t know how many patients will receive the medication as part of the trials, because they cannot predict how many people will qualify and want to participate.
Idaho doesn’t have an endless supply of remdesivir — a drug that has shown promise in treating severe COVID-19. Idaho had enough remdesivir on hand as of late May to treat an estimated 64 patients, based on the state’s distribution plan and average treatment needs. (The U.S. has since bought up almost the entire global supply of remdesivir for through September, hoarding enough to treat more than 500,000 people.) The clinical research at St. Luke’s will not pull from Idaho’s remdesivir supply; instead, the hospital receives additional vials of the drug to use in its trial.
Dr. Karen Miller, a St. Luke’s pulmonologist working on the clinical trials, says it’s noteworthy for the Boise hospital to be one of just dozens of places where patients will participate. Many of the other hospitals are in major cities like New York City, Phoenix and Houston.
St. Luke’s will use the drug only at its Downtown Boise hospital for now, but it may expand later to other hospitals in the health system.
The hospital’s patients will be part of a randomized, double-blind, placebo-controlled clinical trial, which is a gold-standard in drug research, said Cleary Waldren, clinical research manager at St. Luke’s.
In the rush to find a treatment for COVID-19, some early studies weren’t set up that way, and that created false hope when early results didn’t hold up, he said.
“Doing that takes up time, and we don’t have time,” he said.
Waldren said he isn’t concerned that there could be a run on Actemra that makes it hard to access for people who need it for rheumatoid arthritis, because there is a large supply of the drug.
In addition, Waldren said one study will emphasize how treatments work for ethnic-minority patients, who have been harder hit by the coronavirus pandemic. Idaho, for example, has seen a disproportionate level of COVID-19 infections among Latinos.
This story was originally published July 7, 2020 at 3:32 PM.
