Dr Frances Hall is a Consultant Rheumatologist at Cambridge University Hospitals NHS Foundation Trust and Chair of the Eastern Network for Rare Autoimmune Disease. The subset of people who develop severe Covid-19-related disease have a heightened immune response leading to organ damage. The TACTIC programme emerged from the hypothesis that immunomodulation would be likely to reduce the severity of Covid-19-related disease – a model supported by the recent press release from the RECOVERY trial, indicating that a corticosteroid, dexamethasone, reduces mortality in patients with severe disease. TACTIC has been designed to assess selected medications which modify aspects of the immune response. These medications have been chosen by a consortium of clinicians and clinician-scientists with expertise in the treatment of immune-mediated disease and it is hoped that they will further reduce morbidity and mortality from Covid-19-related disease.
TACTIC-R – a trial using licensed drugs “Repurposed” for treatment of Covid-19-related disease launched in Cambridge on 7th May 2020 with three arms in a parallel-group, randomised design:
• Baricitinib – a drug routinely used to treat rheumatoid arthritis, which reduces soluble signals in the immune system called cytokines. It is hypothesised that this will reduce the damaging inflammatory drive in Covid-19-related disease.
• Ravulizumab – a drug used to treat a form of anaemia caused by the person’s immune system; this blocks activation of a cascade of soluble molecules which amplify inflammatory signals and which, ultimately, destroy cells.
• Standard of Care – itself evolving as data emerge from other clinical trials.
This webinar will provide an overview of our current understanding of the mechanisms of tissue damage in Covid-19-related disease and the rationale and design of the TACTIC- R trial, in the context of the evolving therapeutic landscape.
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