Tocilizumab therapy reduced intensive care unit admissions and/or mortality in COVID-19 patients

Abstract

Introduction.-No therapy has yet proven effective in COVID-19. Tocilizumab (TCZ) in patients with severe COVID-19 could be an effective treatment. Method.-We conducted a retrospective case-control study in the Nord Franche-Comté Hospital, France. We compared the outcome of patients treated with TCZ and patients without TCZ considering a combined primary endpoint: death and/or ICU admissions. Results.-Patients with TCZ (n = 20) had a higher Charlson comorbidity index (5.3 [±2.4] vs 3.4 [±2.6], P = 0.014), presented with more severe forms (higher level of oxygen therapy at 13 L/min vs 6 L/min, P < 0.001), and had poorer biological findings (severe lymphopenia: 676/mm 3 vs 914/mm 3 , P = 0.037 and higher CRP level: 158 mg/L vs 105 mg/L, P = 0.017) than patients without TCZ (n = 25). However, death and/or ICU admissions were higher in patients without TCZ than in the TCZ group (72% vs 25%, P = 0.002). Conclusion.-Despite the small sample size and retrospective nature of the work, this result strongly suggests that TCZ may reduce the number of ICU admissions and/or mortality in patients with severe SARS-CoV-2 pneumonia.

Efficacy and safety of tocilizumab in COVID-19 patients: A Meta-Analysis

“…Thus, 28 articles included 991 COVID-19 patients underwent tocilizumab administration were included in this study 10,11, . Of the 28 included studies, 7 of which included 377 patients were case-control studies with a control group not using tocilizumab 28,29,32,36,39,40,42 .…”

“…Data were unavailable for mortality in 3 studies, and a pooled all-cause death rate of 16% (95% CI, 11-22%; I 2 = 67%, P< 0.0001) was reported in 870 patients when treated with tocilizumab. 17 studies 10,11,19,[21][22][23][25][26][27][28][29]31,33,[35][36][37]40 comprising 562 patients were de ned as severe COVID-19 infection, and the pooled ORR of treatment with tocilizumab was 78% (95% CI, 70-85%; I 2 = 65%, P< 0.0001), while pooled ORR in 64 nonsevere infection was 93% (95% CI, 85-98%; I 2 = 0%, P=0.66) ( Figure S2).…”

“…At the point of study completion, median LOH and LOI was 14 days (range 11-34) and 8 days (range [5][6][7][8][9][10][11] in patients receiving tocilizumab, which was speci ed in 15 studies 10,[20][21][22][23]28,29,31,32,35,36,[38][39][40][41] and 8 studies 10,23,27,29,32,33,36,42 , separately. Moreover, the median duration of mechanical ventilation was 7 days (range 5-10) after treatment of tocilizumab which was documented in 9 articles 10,11,[21][22][23]27,28,40,41 ( Table 2).…”

Frequency and severity of Covid-19 in patients treated with biological Disease Modifying Anti-Rheumatic Drugs (bDMARDs) for inflammatory rheumatic disease. A case-control study

“…Rheumatologists are on the very frontline in the management of COVID-19, although very few musculoskeletal disorders have been reported (7). The use of hydroxychloroquine for treating based on the antiviral activity of chloroquine (9)(10) and above all that of Tocilizumab (TCZ) (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), a humanized anti-IL-6 receptor antibody widely used in the treatment of rheumatoid arthritis and juvenile idiopathic arthritis, has put rheumatologists in the spotlight (21,22). Yet TCZ, like other biological Disease Modifying Anti-Rheumatic Drugs (bDMARDs), has been classi ed as a potentially immunosuppressive drug due to the increased risk of severe infection in patients treated with bDMARDs (23).…”

Matched Cohort Study on the Efficacy of Tocilizumab in Patients with COVID-19&nbsp;

“…However, e cacy of tocilizumab in COVID-19 disease, has yet to be demonstrated. To date no results from randomized clinical trials testing tocilizumab have been reported and, the few observational studies which has a comparative group, report con ictive results on mortality or clinical improvement (6)(7)(8)(9).…”