Tocilizumab for the treatment of COVID-19

Review Pharmacology & Pharmacy

Efficacy and safety of tocilizumab versus standard care/placebo in patients with COVID-19; a systematic review and meta-analysis of randomized clinical trials

Driton Vela et al.

Summary: Tocilizumab has shown efficacy and safety in treating patients with COVID-19. Its use reduces all-cause mortality and the risk of progression to mechanical ventilation without increasing serious adverse events.

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (2022)

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Article Infectious Diseases

ESCMID COVID-19 living guidelines: drug treatment and clinical management

Michele Bartoletti et al.

Summary: This article introduces the establishment and working process of the ESCIMD COVID-19 guidelines task force, and outlines their recommendations for COVID-19 treatment. They provide recommendations for treatment measures, while also pointing out situations where the use of certain drugs is not recommended or should be approached with caution. The article also states that these recommendations are only applicable to adult patients, and emphasizes the backgrounds and limitations of the panel members.

CLINICAL MICROBIOLOGY AND INFECTION (2022)

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Article Critical Care Medicine

Prognostic and Predictive Biomarkers in Patients With Coronavirus Disease 2019 Treated With Tocilizumab in a Randomized Controlled Trial*

Jennifer Tom et al.

Summary: This study aimed to explore the prognostic and predictive biomarkers in patients with coronavirus disease 2019 pneumonia treated with tocilizumab. The results showed that multiple biomarkers were prognostic for clinical outcomes in these patients, and high ferritin levels were associated with better clinical outcomes with tocilizumab.

CRITICAL CARE MEDICINE (2022)

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Review Pharmacology & Pharmacy

Comparing the efficacy of tocilizumab with corticosteroid therapy in treating COVID-19 patients: a systematic review and meta-analysis

Phei Ching Lim et al.

Summary: Tocilizumab and dexamethasone have emerged as viable options to reduce mortality in severe COVID-19 patients. Randomized controlled trials showed that these two drugs can reduce mortality, while case-control studies showed that tocilizumab and the combination of tocilizumab and methylprednisolone can reduce mortality.

DARU-JOURNAL OF PHARMACEUTICAL SCIENCES (2022)

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Article Public, Environmental & Occupational Health

Efficacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients

Rania M. Sarhan et al.

Summary: The effectiveness of tocilizumab-hydroxychloroquine (TCZ-HCQ) and tocilizumab-remdesivir (TCZ-RMV) combinations were observed in the treatment of severe COVID-19 patients. However, the TCZ-RMV group had a higher incidence of ICU or mechanical ventilation and a greater risk of cardiac and thrombotic events.

JOURNAL OF INFECTION AND PUBLIC HEALTH (2022)

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Article Immunology

Safety and Efficacy of Tocilizumab 4 or 8 mg/kg in Hospitalized Patients With Moderate to Severe Coronavirus Disease 2019 Pneumonia: A Randomized Clinical Trial

Princy N. Kumar et al.

Summary: This study investigated the optimal dose of tocilizumab in patients with moderate to severe COVID-19 pneumonia. The pharmacokinetic and pharmacodynamic assessments showed dose-dependent effects, and the safety profile was comparable between different doses. However, further research is needed to determine if a lower dose can be recommended for COVID-19 pneumonia patients.

OPEN FORUM INFECTIOUS DISEASES (2022)

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Article Infectious Diseases

Early administration of tocilizumab in hospitalized COVID-19 patients with elevated inflammatory markers; COVIDSTORM-a prospective, randomized, single-centre, open-label study

Niklas Broman et al.

Summary: Severe COVID-19 patients with enhanced inflammation showed improved clinical recovery and shorter hospitalization when treated with tocilizumab compared to standard of care alone, according to this study.

CLINICAL MICROBIOLOGY AND INFECTION (2022)

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Review Medicine, General & Internal

Effectiveness of tocilizumab in the treatment of hospitalized adults COVID-19 A systematic review and meta-analysis

Jing Zhang et al.

Summary: Tocilizumab reduces mortality, mechanical ventilation rate, intensive care unit admission, and serious infections in hospitalized COVID-19 patients. Further studies are needed to determine the optimal dosage.

MEDICINE (2022)

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Review Immunology

Clinical efficacy and safety of interleukin-6 receptor antagonists (tocilizumab and sarilumab) in patients with COVID-19: a systematic review and meta-analysis

Su-Yeon Yu et al.

Summary: This study found that IL-6 receptor antagonists, when used in combination with standard care treatment, can significantly reduce all-cause mortality and the risk of progression to invasive mechanical ventilation in COVID-19 patients. Particularly, tocilizumab treatment showed significant benefits in reducing mortality and mechanical ventilation risk in patients with moderate-to-severe COVID-19. The frequency of serious adverse events was lower in the tocilizumab treatment group compared to the standard of care treatment group.

EMERGING MICROBES & INFECTIONS (2022)

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Article Multidisciplinary Sciences

Timely administration of tocilizumab improves outcome of hospitalized COVID-19 patients

Abraham Rutgers et al.

Summary: This study aimed to evaluate the efficacy of early tocilizumab treatment in hospitalized patients with COVID-19. The results showed that early use of tocilizumab in patients needing oxygen support can reduce mortality and the need for mechanical ventilation within 30 days. Additionally, the combination of tocilizumab and dexamethasone appears to enhance its efficacy.

PLOS ONE (2022)

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Article Infectious Diseases

Pembrolizumab in combination with tocilizumab in high-risk hospitalized patients with COVID-19 (COPERNICO): A randomized proof-of-concept phase II study

Matilde Sanchez-Conde et al.

Summary: The study evaluated the efficacy and safety of Pembrolizumab and tocilizumab in hospitalized COVID-19 pneumonia patients at high risk without mechanical ventilation. The results showed that adding Pembrolizumab and tocilizumab to the treatment regimen reduced the hospitalization period, resulted in faster discharges, and had no adverse effects.

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES (2022)

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Article Medicine, General & Internal

Adding colchicine to tocilizumab in hospitalized patients with severe COVID-19 pneumonia: An open-label randomized controlled trial

Alaa Rahhal et al.

Summary: This study aims to evaluate the effectiveness and safety of adding colchicine to tocilizumab in severe COVID-19 pneumonia patients to reduce the rate of invasive mechanical ventilation and mortality. Colchicine, as a potential anti-inflammatory agent, has a different mechanism of action compared to other IL-6 antagonists, and it is easy to use, cost-effective, and safe.

MEDICINE (2022)

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Article Medicine, General & Internal

Tocilizumab in patients hospitalised with COVID-19 pneumonia: Efficacy, safety, viral clearance, and antibody response from a randomised controlled trial (COVACTA)

Ivan O. Rosas et al.

Summary: Tocilizumab did not improve mortality in COVID-19 patients through day 60, but it shortened hospital stay and did not impair viral clearance or antibody response. No new safety signals were observed. Future research may explore biomarkers for patient selection and combination therapy.

ECLINICALMEDICINE (2022)

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Article Immunology

Tocilizumab for Treatment of Mechanically Ventilated Patients With COVID-19

Emily C. Somers et al.

Summary: In mechanically ventilated COVID-19 patients, the use of IL-6 blockade with tocilizumab was associated with lower mortality despite higher occurrence of superinfections.

CLINICAL INFECTIOUS DISEASES (2021)

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Article Infectious Diseases

Tocilizumab for patients with severe COVID-19: a retrospective, multi-center study

Krzysztof Tomasiewicz et al.

Summary: The study suggests that tocilizumab can effectively control the symptoms of severe COVID-19 by reducing the inflammatory response and rapidly improving the clinical status in most patients.

EXPERT REVIEW OF ANTI-INFECTIVE THERAPY (2021)

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Article Medicine, Research & Experimental

Tocilizumab combined with favipiravir in the treatment of COVID-19: A multicenter trial in a small sample size

Hong Zhao et al.

Summary: The study found that tocilizumab combined with or without favipiravir can effectively improve pulmonary inflammation in COVID-19 patients, alleviate clinical symptoms, and help blood routine return to normal.

BIOMEDICINE & PHARMACOTHERAPY (2021)

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Review Immunology

Decreased Mortality in Coronavirus Disease 2019 Patients Treated With Tocilizumab: A Rapid Systematic Review and Meta-analysis of Observational Studies

Jishnu Malgie et al.

Summary: This systematic review found that COVID-19 patients treated with tocilizumab (TCZ) had lower mortality rates compared to those not treated with TCZ. However, there were no significant differences observed in terms of side effects between the two groups.

CLINICAL INFECTIOUS DISEASES (2021)

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Article Allergy

IL-6 serum levels predict severity and response to tocilizumab in COVID-19: An observational study

Jose Maria Galvan-Roman et al.

Summary: Baseline IL-6 greater than 30 pg/mL predicts the need for IMV in COVID-19 patients, and early TCZ treatment can improve oxygenation. Patients with high IL-6 not treated with TCZ show high mortality.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY (2021)

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Article Medicine, General & Internal

Association Between Early Treatment With Tocilizumab and Mortality Among Critically Ill Patients With COVID-19

Shruti Gupta et al.

Summary: A multicenter cohort study found that early treatment with tocilizumab may reduce mortality among critically ill patients with COVID-19. Further research from randomized clinical trials is needed to confirm these findings.

JAMA INTERNAL MEDICINE (2021)

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Article Medicine, General & Internal

Effect of Tocilizumab vs Usual Care in Adults Hospitalized With COVID-19 and Moderate or Severe Pneumonia A Randomized Clinical Trial

Olivier Hermine et al.

Summary: In this clinical trial of COVID-19 patients with pneumonia requiring oxygen support but not in the ICU, tocilizumab did not reduce WHO-CPS scores below 5 by day 4 but may have reduced the risk of needing noninvasive ventilation, mechanical ventilation, or death by day 14. There was no difference in mortality by day 28. Further studies are needed to confirm these preliminary results.

JAMA INTERNAL MEDICINE (2021)

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Article Medicine, General & Internal

Effect of Tocilizumab vs Standard Care on Clinical Worsening in Patients Hospitalized With COVID-19 Pneumonia A Randomized Clinical Trial

Carlo Salvarani et al.

Summary: This study evaluated the use of tocilizumab in hospitalized COVID-19 pneumonia patients and found no significant benefit compared to standard care. Further randomized clinical trials with blinded, placebo-controlled methods are needed to confirm these results and explore potential applications of tocilizumab in different stages of the disease.

JAMA INTERNAL MEDICINE (2021)

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Article Medicine, General & Internal

Tocilizumab in Patients Hospitalized with Covid-19 Pneumonia

Carlos Salama et al.

Summary: Among hospitalized patients with Covid-19 pneumonia not on mechanical ventilation, tocilizumab reduced the risk of progression to mechanical ventilation or death, but did not improve overall survival. There were no new safety concerns identified.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

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Article Critical Care Medicine

Tocilizumab and remdesivir in hospitalized patients with severe COVID-19 pneumonia: a randomized clinical trial

Ivan O. Rosas et al.

Summary: In patients with severe COVID-19 pneumonia, tocilizumab plus remdesivir did not reduce the time to hospital discharge or readiness for discharge compared to placebo plus remdesivir by day 28.

INTENSIVE CARE MEDICINE (2021)

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Article Medicine, General & Internal

Effect of tocilizumab on clinical outcomes at 15 days in patients with severe or critical coronavirus disease 2019: randomised controlled trial

Viviane C. Veiga et al.

Summary: The study found that in patients with severe or critical COVID-19, tocilizumab in combination with standard care was not superior to standard care alone in improving clinical outcomes at 15 days, and it might increase mortality.

BMJ-BRITISH MEDICAL JOURNAL (2021)

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Review Pharmacology & Pharmacy

The effect of tocilizumab on mortality in hospitalized patients with COVID-19: a meta-analysis of randomized controlled trials

Chia Siang Kow et al.

Summary: The meta-analysis did not find significant mortality benefits with the use of tocilizumab among patients with COVID-19, but it appears to reduce the likelihood of progression to mechanical ventilation.

EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY (2021)

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Article Medicine, General & Internal

Tocilizumab in Hospitalized Patients with Severe Covid-19 Pneumonia

I. O. Rosas et al.

Summary: In this randomized trial involving hospitalized patients with severe Covid-19 pneumonia, the use of tocilizumab did not result in significantly better clinical status or lower mortality than placebo at 28 days.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

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Article Medicine, General & Internal

Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19

Anthony C. Gordon et al.

Summary: Interleukin-6 receptor antagonists tocilizumab and sarilumab were found to improve outcomes, including survival, in critically ill patients with Covid-19 receiving organ support in ICUs according to an ongoing international trial. The efficacy of these treatments has been confirmed, with patients benefiting from the therapy.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

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Article Critical Care Medicine

Tocilizumab plus standard care versus standard care in patients in India with moderate to severe COVID-19-associated cytokine release syndrome (COVINTOC): an open- label, multicentre, randomised, controlled, phase 3 trial

Arvinder S. Soin et al.

Summary: The study recruited 180 patients and found that tocilizumab did not reduce disease progression in patients with moderate to severe COVID-19, but may have some effect in severe cases.

LANCET RESPIRATORY MEDICINE (2021)

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Article Oncology

Tocilizumab in patients with moderate or severe COVID-19: a randomized, controlled, open-label, multicenter trial

Dongsheng Wang et al.

Summary: Tocilizumab may be effective in COVID-19 patients by improving hypoxia. This treatment is particularly beneficial in patients with bilateral pulmonary lesions and elevated IL-6 levels.

FRONTIERS OF MEDICINE (2021)

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Article Medicine, General & Internal

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Obbina Abani et al.

LANCET (2021)

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Article Medicine, General & Internal

Tocilizumab Improves the Prognosis of COVID-19 in Patients with High IL-6

Robert Flisiak et al.

Summary: The study demonstrated the significant impact of tocilizumab on reducing mortality and accelerating clinical improvement in COVID-19 patients with a baseline concentration of IL-6 > 100 pg/mL, particularly those who require oxygen supplementation.

JOURNAL OF CLINICAL MEDICINE (2021)

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Article Medicine, General & Internal

Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19 AMeta-analysis

Manu Shankar-Hari et al.

Summary: This study identified 27 clinical trials and found that the use of IL-6 antagonists was associated with lower 28-day all-cause mortality in patients hospitalized for COVID-19 compared to usual care or placebo. Different risk effects were observed between tocilizumab and sarilumab, increasing understanding of the treatment with these drugs.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2021)

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Article Respiratory System

Tocilizumab in Hospitalized Patients with COVID-19: A Meta Analysis of Randomized Controlled Trials

Vijairam Selvaraj et al.

Summary: Tocilizumab therapy reduces mortality and need for mechanical ventilation in hospitalized COVID-19 patients compared to standard therapy or placebo, and also shows a trend towards improved time to discharge.

LUNG (2021)

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Article Public, Environmental & Occupational Health

Intravenous methylprednisolone with or without tocilizumab in patients with severe COVID-19 pneumonia requiring oxygen support: A prospective comparison

Dujana Mostafa Hamed et al.

Summary: In severe COVID-19 pneumonia patients on oxygen support, a 7-day course of daily methylprednisolone reduced mortality at 45 days and significantly decreased ICU admission and ventilation rates. The addition of tocilizumab to methylprednisolone did not significantly improve any of the studied outcomes.

JOURNAL OF INFECTION AND PUBLIC HEALTH (2021)

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Article Immunology

Effectiveness of Tocilizumab with and without Dexamethasone in Patients with Severe COVID-19: A Retrospective Study

Dorota Zarebska-Michaluk et al.

Summary: This study compared the effectiveness of tocilizumab (TCZ) and dexamethasone (DEX) administered alone or in combination in patients with severe COVID-19. The results showed that in severe patients, treatment with TCZ alone was better in terms of survival and clinical improvement than DEX, and the combination of TCZ and DEX did not improve therapy effectiveness.

JOURNAL OF INFLAMMATION RESEARCH (2021)

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Article Medicine, General & Internal

High-Dose Dexamethasone Versus Tocilizumab in Moderate to Severe COVID-19 Pneumonia: A Randomized Controlled Trial

Naveen B. Naik et al.

Summary: The study found that in patients with moderate to severe COVID-19 ARDS, high-dose dexamethasone (HDD) had lower VFDs compared to tocilizumab (TCZ), and the HDD group had higher 28-day mortality and incidence of adverse events. Therefore, HDD is not recommended for mitigating the cytokine storm in moderate to severe COVID-19 ARDS, and TCZ appears to be a better and safer alternative.

CUREUS JOURNAL OF MEDICAL SCIENCE (2021)

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Article Multidisciplinary Sciences