What about tocilizumab? A retrospective study from a NYC Hospital during the COVID-19 outbreak

Link to article at PubMed

PLoS One. 2021 Apr 8;16(4):e0249349. doi: 10.1371/journal.pone.0249349. eCollection 2021.

ABSTRACT

BACKGROUND: Tocilizumab, an interleukin-6 receptor blocker, has been used in the inflammatory phase of COVID-19, but its impact independent of corticosteroids remains unclear in patients with severe disease.

METHODS: In this retrospective analysis of patients with COVID-19 admitted between March 2 and April 14, 2020 to a large academic medical center in New York City, we describe outcomes associated with tocilizumab 400 mg (without methylprednisolone) compared to a propensity-matched control. The primary endpoints were change in a 7-point ordinal scale of oxygenation and ventilator free survival, both at days 14 and 28. Secondary endpoints include incidence of bacterial superinfections and gastrointestinal perforation. Primary outcomes were evaluated using t-test.

RESULTS: We identified 33 patients who received tocilizumab and matched 74 controls based on demographics and health measures upon admission. After adjusting for illness severity and baseline ordinal scale, we failed to find evidence of an improvement in hypoxemia based on an ordinal scale at hospital day 14 in the tocilizumab group (OR 2.2; 95% CI, 0.7-6.5; p = 0.157) or day 28 (OR 1.1; 95% CI, 0.4-3.6; p = 0.82). There also was no evidence of an improvement in ventilator-free survival at day 14 (OR 0.8; 95% CI, 0.18-3.5; p = 0.75) or day 28 (OR 1.1; 95% CI, 0.1-1.8; p = 0.23). There was no increase in secondary bacterial infection rates in the tocilizumab group compared to controls (OR 0.37; 95% CI, 0.09-1.53; p = 0.168).

CONCLUSIONS: There was no evidence to support an improvement in hypoxemia or ventilator-free survival with use of tocilizumab 400 mg in the absence of corticosteroids. No increase in secondary bacterial infections was observed in the group receiving tocilizumab.

PMID:33831046 | DOI:10.1371/journal.pone.0249349

One Comment

  1. The 202 pro-Actemra studies and 48+6 pro-Actemra meta-analyses shown below are all for treating COVID-19, not other diseases:

    The head researchers of the 45 pro-Actemra studies from the United States are:
    Ali, Antony, Biran, Brosnahan, Chilimuri, Farooqi, Shruti Gupta, Hitawala, Huang, Iglesias, Ignatius, Ip, Jordan, Kaminski, Kewan, Kumar, Ladna, Lewis, Meleveedu, Mo, Morin, Morrison, Narain, Nigo, Oliva, Patel, Peaytt, Petrak, Price, Rajendram, Ramaswamy, Rojas-Marte, Salama, Saliaj, Singh, Sinha, Sirimaturos, Somers, Strohbehn, Suresh, Tarun, Tom, Villatoro-Santos, Vu, Wadud

    The head researchers of the 7 pro-Actemra meta-analyses from the United States are:
    Antwi-Amoabeng, Aziz, Boregowda, Samiksha Gupta, Kaye, Mutua, Selvaraj

    The head researchers of the 27 pro-Actemra studies from Italy are:
    Berlot, Canziani, Capici, Capra, Cellina, Coloretti, De Rossi, Di Nisio, Fanelli, Giambenedetto, Guaraldi, Guglielmetti, Masci, Mastroianni, Melegari, Menzella, Mikulska, Milic, Montini, Perrone, Potere2, Rossotti, Russo, Salvati, Sciascia, Toniati

    The head researchers of the 4 pro-Actemra meta-analyses from Italy are:
    Berardicurti, Conti, Maraolo, Petrelli

    The head researcher of the 1 pro-Actemra IL-6 meta-analysis from Italy is:
    Belletti

    The head researchers of the 26 pro-Actemra studies from Spain are:
    Alvarez-Mon, Ardanaz, Buzón-Martín, Cáceres, Corominas, Diaz, Fernández-Ruiz, Freire-Álvarez, González-Castro, Guillén, Olivares-Hernández, Jiménez-Brítez, López-Medrano, Martínez-Sanz, Masiá, Millán, Moreno-García, Moreno-Pérez, Rodríguez-Baño, Rubio-Rivas2, Ruiz-Antorán, Sánchez-Montalvá, Sánchez-Rovira, Van den Eynde, Vizcarra

    The head researcher of the 1 pro-Actemra meta-analysis from Spain is:
    Rubio-Rivas (ongoing updates)

    The head researchers of the 15 pro-Actemra studies from China are:
    Binqing Fu, Qin Hu, Weijun Jiang, Pan Li, Aihua Liu, Pan Luo, Jianbo Tian, Dongsheng Wang, Xiaoling Xu, Yun Yang, Jia Zeng, Chi Zhang, Xuhan Zhang, Hong Zhao, Kai-Lian Zheng

    The head researchers of the 7 pro-Actemra meta-analyses from China are:
    Chun Chen, Weijun Jiang, Zhenlu Li, Lili Luo plus Ting Luo, Qiu Wei, Jie Zhao, Meng Zhao

    The head researchers of the 16 pro-Actemra studies from France are:
    Albertini, Conrozier, De Luna, Dernoncourt, Hermine, Issa, Klopfenstein2, Lohse, Mariette, Michot, Odièvre, Richier, de Roquetaillade, Rossi, Roumier

    The head researcher of the 1 pro-Actemra meta-analysis from France is:
    Klopfenstein

    The head researchers of the 4 pro-Actemra studies from Pakistan are:
    Chachar, Mushtaq2, Nasir

    The head researchers of the 2 pro-Actemra meta-analyses from Pakistan are:
    Kotak, Sarfraz

    The head researchers of the 2 pro-Actemra studies from Australia are:
    Webb, West

    The head researchers of the 8 pro-Actemra studies from India are:
    Bhandari, Desai, Dravid, Gokhale2, Madan, Soin

    The head researcher of the 1 pro-Actemra meta-analysis from India is:
    Viswanatha

    The head researchers of the 5 pro-Actemra studies from Poland are:
    Chocho?-Labun, Flisiak, Tomasiewicz, Zar?bska-Michaluk, Zielecki

    The head researcher of the 1 pro-Actemra meta-analysis from Poland is:
    Grygiel-Górniak

    The head researchers of the 3 pro-Actemra studies from the United Arab Emirates are:
    Shazia Abdullah, Sudeendra Gupta, Prashant Nasa

    The head researcher of the 1 pro-Actemra study from Canada is:
    Yang

    The head researchers of the 2 pro-Actemra IL-6 meta-analyses from Canada are:
    Angriman, Coomes

    The head researcher of the 1 pro-Actemra study from Indonesia is:
    Widysanto

    The head researchers of the 5 pro-Actemra meta-analyses from Indonesia are:
    Handriani, Hariyanto, Nugroho, Pinzon, Wafa

    The head researchers of the 2 pro-Actemra studies from Iran are:
    Dastan, Malekzadeh

    The head researchers of the 2 pro-Actemra meta-analyses from Iran are:
    Moosazadeh, Rezaei

    The head researcher of the 1 pro-Actemra IL-6 meta-analysis from Iran is:
    Mojtabavi

    The head researchers of the 5 pro-Actemra studies from Turkey are:
    Celik, E?kazan, Keske, Küçük, Uysal

    The head researcher of the 1 pro-Actemra study from Argentina is:
    Galvalisi

    The head researcher of the 1 pro-Actemra study from Bangladesh is:
    Rabbani

    The head researchers of the 4 pro-Actemra studies from Brazil are:
    Albuquerque, Beltrão, Carvalho, Senegaglia

    The head researcher of the 1 pro-Actemra study from Chile is:
    Valenzuela

    The head researcher of the 1 pro-Actemra study from Ecuador is:
    Cherrez-Ojeda

    The head researchers of the 2 pro-Actemra studies from Egypt are:
    Abdelnaby, Sarhan

    The head researcher of the 1 pro-Actemra meta-analysis from Egypt is:
    Hasanin

    The head researcher of the 1 pro-Actemra study from Germany is:
    Budweiser

    The head researcher of the 1 pro-Actemra study from Ghana is:
    Hardy

    The head researcher of the 1 pro-Actemra study from Hungary is:
    Lakatos

    The head researchers of the 2 pro-Actemra studies from Ireland are:
    McCarthy, Nurdin

    The head researchers of the 2 pro-Actemra studies from Japan are:
    Masataro Toda, Ken-ichi Muramatsu

    The head researcher of the 1 pro-Actemra study from Kuwait is:
    Al-Shamali

    The head researcher of the 1 pro-Actemra study from Kyrgyzstan is:
    Ashimov

    The head researcher of the 1 pro-Actemra study from Lebanon is:
    Nourié

    The head researcher of the 1 pro-Actemra meta-analysis from Lebanon is:
    Alam

    The head researcher of the 1 pro-Actemra study from Mexico is:
    Durán-Méndez

    The head researcher of the 1 pro-Actemra study from Morocco is:
    El Rhalete

    The head researcher of the 1 pro-Actemra study from Nepal is:
    Adhikari

    The head researchers of the 2 pro-Actemra studies from Oman are:
    Harthi, Khamis

    The head researcher of the 1 pro-Actemra study from the Philippines is:
    Aparece-Solis

    The head researcher of the 1 pro-Actemra study from Qatar is:
    Alattar

    The head researchers of the 2 pro-Actemra studies from Romania are:
    Birlutiu, Miftode

    The head researcher of the 1 pro-Actemra study from Russia is:
    Fomina

    The head researcher of the 1 pro-Actemra study from Sweden is:
    Eimer

    The head researcher of the 1 pro-Actemra study from Switzerland is:
    Sava

    The head researchers of the 3 pro-Actemra studies from Taiwan are:
    Yen-Wen Chen, Huei-Yu Lo, Shi-Ming Tsao

    The head researcher of the 1 pro-Actemra meta-analysis from Taiwan is:
    Tzu-Rong Peng

    The head researchers of the 3 pro-Actemra studies from the United Kingdom are:
    Chalmers?, Gentile, Gordon?, Horby, Tenda

    The head researchers of the 3 pro-Actemra meta-analyses from the United Kingdom are:
    Khan, Podmore, Snow

    The head researcher of the 1 pro-Actemra IL-6 meta-analysis from the United Kingdom is:
    Tharmarajah

    The head researcher of the 1 pro-Actemra meta-analysis from Greece is:
    Kyriakopoulos

    The head researchers of the 2 pro-Actemra studies from Holland are:
    Moes, Rutgers

    The head researcher of the 1 pro-Actemra meta-analysis from Holland is:
    Malgie

    The head researchers of the 2 pro-Actemra meta-analyses from Israel are:
    Tomer Avni, Naim Mahroum

    The head researcher of the 1 pro-Actemra meta-analysis from Kosovo is:
    Vela

    The head researchers of the 2 pro-Actemra studies from Saudi Arabia are:
    Al-Baadani, Mady

    The head researchers of the 3 pro-Actemra meta-analyses from Saudi Arabia are:
    Abdulrahman, Alkofide, Tleyjeh (ongoing updates)

    The head researcher of the 1 pro-Actemra IL-6 meta-analysis from Thailand is:
    Meanwatthana

    The head researcher of the 10,930-patient, global pro-Actemra meta-analysis from the World Health Organization is:
    Shankar-Hari

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