Pulmonology . Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review

[tetano]

Pulmonology


. 2020 Jul 20;S2531-0437(20)30153-7.
doi: 10.1016/j.pulmoe.2020.07.003. Online ahead of print.
Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review


A Cortegiani ¹ , M Ippolito ² , M Greco ³ , V Granone ⁴ , A Protti ⁵ , C Gregoretti ⁶ , A Giarratano ⁷ , S Einav ⁸ , M Cecconi ⁹



Affiliations

• PMID: 32713784
• DOI: 10.1016/j.pulmoe.2020.07.003

Abstract

Background: Tocilizumab is an IL-6 receptor-blocking agent proposed for the treatment of severe COVID-19. The aim of this systematic review was to describe the rationale for the use of tocilizumab for the treatment of COVID-19 and to summarize the available evidence regarding its efficacy and safety.
Methods: MEDLINE, PubMed, EMBASE, pre-print repositories (bioRxiv and medRxiv) and two trial Registries were searched for studies on the use of tocilizumab in COVID-19 or SARS-CoV-2 infection, viral pneumonia, and/or sepsis until 20th June 2020.
Results: We identified 3 indirect pre-clinical studies and 28 clinical studies including 5776 patients with COVID-19 (13 with a comparison group, 15 single-arm). To date, no randomized trials have been published. We retrieved no studies at low risk of bias. Forty-five ongoing studies were retrieved from trial registries.
Conclusions: There is insufficient evidence regarding the clinical efficacy and safety of tocilizumab in patients with COVID-19. Its use should be considered experimental, requiring ethical approval and clinical trial oversight.

Keywords: COVID-19; Coronavirus; Pneumonia; SARS-CoV-2; Tocilizumab.