24 June 2021 - - The US Food and Drug Administration has issued an Emergency Use Authorization for intravenous Actemra (tocilizumab) for the treatment of COVID-19 in hospitalized adults and pediatric patients (2 years of age and older) who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation, US-based biotechnology company Genentech, a member of Switzerland's Roche Group (SIX: RO) (OTCQX: RHHBY) said.

The EUA is based on results from four randomized, controlled studies that evaluated Actemra for the treatment of COVID-19 in more than 5,500 hospitalized patients.

The results of these studies suggest that Actemra may improve outcomes in patients receiving corticosteroids and requiring supplemental oxygen or breathing support.

The four randomized, controlled studies included in the EUA submission investigated the safety and efficacy of Actemra in more than 5,500 hospitalized patients with COVID-19.

The RECOVERY Actemra study was led by researchers in the United Kingdom and included more than 4,000 hospitalized COVID-19 patients. Genentech-sponsored global trials included the placebo-controlled EMPACTA, COVACTA and REMDACTA studies.

There have been no new safety signals identified for Actemra in any of these studies. The most common adverse reactions seen (incidence ≥ 3%) are constipation, anxiety, diarrhea, insomnia, hypertension and nausea.

The FDA Letter of Authorization and Fact Sheets for patients and health care professionals are available for download with the latest information on this EUA. For more information on how Genentech is responding to the global COVID-19 pandemic, visit our COVID-19 response page.

Actemra has not been approved by the US FDA in this setting, but the FDA has made Actemra available under an emergency access mechanism called an EUA as a treatment for certain patients with COVID-19.

There is limited information known about the safety or effectiveness of using Actemra to treat people in the hospital with COVID-19.

The EUA is supported by a secretary of Health and Human Services declaration that circumstances exist to justify the emergency use of drugs and biological products during the COVID-19 pandemic.

The authorization is temporary and does not replace the formal review and approval process.

Actemra is authorized under the EUA only for the duration of the declaration that circumstances exist justifying the authorization of the emergency use of Actemra under Section 564(b) (1) of the Act, 21 USC. § 360bbb-3(b) (1), unless the authorization is terminated or revoked sooner.

Genentech has existing distribution channels established to ship Actemra to hospitals across the United States.

Genentech's clinical trial program evaluated the safety and efficacy of Actemra in hospitalized patients with COVID-19.

Actemra is not FDA-approved for this use and there is limited information known about the safety or effectiveness of using Actemra to treat people in the hospital with COVID-19. 

COVACTA and EMPACTA were the first two global Phase III, multicenter, randomized, placebo-controlled studies of Actemra in patients hospitalized with COVID-19 associated pneumonia.

COVACTA was conducted in collaboration with the Biomedical Advanced Research and Development Authority (BARDA), part of the Office of the Assistant secretary for Preparedness and Response at the United States Department of Health and Human Services.

EMPACTA aimed to address research questions about the safety and efficacy of Actemra in underserved populations by emphasizing enrollment from minority patients often underrepresented in clinical trials. Both studies were published in the New England Journal of Medicine.

Genentech also partnered with Gilead Sciences, Inc., on REMDACTA, a Phase III, randomized, double-blind, multicenter study to evaluate the safety and efficacy of Actemra plus Veklury (remdesivir), versus placebo plus Veklury, in hospitalized patients with severe COVID-19 associated pneumonia.

Actemra was the first humanized interleukin-6 receptor antagonist approved for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have used one or more disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, that did not provide enough relief.

The extensive Actemra RA IV clinical development program included five Phase III clinical studies and enrolled more than 4,000 people with RA in 41 countries.

The Actemra RA subcutaneous clinical development program included two Phase III clinical studies and enrolled more than 1,800 people with RA in 33 countries.

Actemra subcutaneous injection is also approved for the treatment of adult patients with giant cell arteritis, for the treatment of patients two years of age and older with active polyarticular juvenile idiopathic arthritis or active systemic juvenile idiopathic arthritis, and for slowing the rate of decline in pulmonary function in adult patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD).

In addition, Actemra is also approved in the IV formulation for patients two years of age and older with active PJIA, SJIA or CAR T cell-induced cytokine release syndrome. Actemra is not approved for subcutaneous use in people with CRS.

It is not known if Actemra is safe and effective in children with PJIA, SJIA or CRS under two years of age or in children with conditions other than PJIA, SJIA or CRS.