tetano
Editor, Senior Moderator
Expert Rev Anti Infect Ther
. 2022 Feb 24.
doi: 10.1080/14787210.2022.2046462. Online ahead of print.
Tocilizumab effectiveness in mechanically ventilated COVID-19 patients (T-MVC-19 Study): amulticenter real-world evidence
Yahya A Mohzari[SUP] 1 [/SUP], Ahmad Alamer[SUP] 2 [/SUP], Majda Alattas[SUP] 3 [/SUP], Ahmed A Alrashed[SUP] 4 [/SUP], Nura A Alshehab[SUP] 5 [/SUP], Turkiah K Alkhaldi[SUP] 6 [/SUP], Amnah A Alamer[SUP] 7 [/SUP], Syed M B Asdaq[SUP] 8 [/SUP], Doaa Aljefri[SUP] 9 [/SUP], Hamdan N Alajami[SUP] 10 [/SUP], Yazed S Alsowaida[SUP] 11 [/SUP], Maya Mathew[SUP] 12 [/SUP], Mohammed I Al-Musawa[SUP] 13 [/SUP], Mukhtar Alomar[SUP] 14 [/SUP], Raghad Y Alharbi[SUP] 15 [/SUP], Malik Khuwaja[SUP] 16 [/SUP], Reem F Bamogaddam[SUP] 12 [/SUP], Ashwaq H Alharthi[SUP] 17 [/SUP], Aisha Y Faqihi[SUP] 18 [/SUP], Bashayer F Alrumayyan[SUP] 18 [/SUP], Abeer Alshareef[SUP] 17 [/SUP], Batool M Alhassan[SUP] 19 [/SUP], Nader Y Damfu[SUP] 20 [/SUP], Ghada S Alajmi[SUP] 17 [/SUP], Asma Albujaidy[SUP] 21 [/SUP], Maram Alghalbi[SUP] 22 [/SUP], Saleh A Alajlan[SUP] 23 [/SUP], Ivo Abraham[SUP] 24 [/SUP], Abdulaziz S Almulhim[SUP] 25 [/SUP]
Affiliations
Abstract
Background: This study aimed to evaluate the effectiveness of tocilizumab in mechanically ventilated patients with coronavirus disease 2019 (COVID-19).
Research design and methods: This retrospective multicenter study included adults (≥18 years), diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by real-time polymerase chain reaction (RT-PCR) from nasopharyngeal swab, and requiring invasive mechanical ventilation during admission. Survival analyses with inverse propensity score treatment weighting (IPTW) and propensity score matching (PSM) were conducted. To account for immortal bias, we used Cox proportional modelling with time-dependent covariance. Competing risk analysis was performed for the extubation endpoint.
Results: A total of 556 (tocilizumab=193, control=363) patients were included. Males constituted the majority of the participants (69.2% in tocilizumab arm,74.1% in control arm). Tocilizumab was not associated with a reduction in mortality with hazard ratio (HR)=0.82 (95% confidence interval (CI: 0.62 to 1.10) in the Inverse propensity score weighting (IPTW) analysis and HR=0.86(95% CI: 0.64 to 1.16, P=0.349) in the PSM analysis. However, tocilizumab was associated with an increased rate of extubation (33.6%) compared to the control group (11.9%; subdistributional hazards (SHR)=3.1, 95% CI:1.86 to 5.16).
Conclusions: Although tocilizumab was not found to be effective in reducing mortality, extubation rate while on mechanical ventilation was higher among tocilizumab-treated group.
Keywords: COVID-19; Effectiveness; Mechanical ventilation; Mortality; Tocilizumab.
. 2022 Feb 24.
doi: 10.1080/14787210.2022.2046462. Online ahead of print.
Tocilizumab effectiveness in mechanically ventilated COVID-19 patients (T-MVC-19 Study): amulticenter real-world evidence
Yahya A Mohzari[SUP] 1 [/SUP], Ahmad Alamer[SUP] 2 [/SUP], Majda Alattas[SUP] 3 [/SUP], Ahmed A Alrashed[SUP] 4 [/SUP], Nura A Alshehab[SUP] 5 [/SUP], Turkiah K Alkhaldi[SUP] 6 [/SUP], Amnah A Alamer[SUP] 7 [/SUP], Syed M B Asdaq[SUP] 8 [/SUP], Doaa Aljefri[SUP] 9 [/SUP], Hamdan N Alajami[SUP] 10 [/SUP], Yazed S Alsowaida[SUP] 11 [/SUP], Maya Mathew[SUP] 12 [/SUP], Mohammed I Al-Musawa[SUP] 13 [/SUP], Mukhtar Alomar[SUP] 14 [/SUP], Raghad Y Alharbi[SUP] 15 [/SUP], Malik Khuwaja[SUP] 16 [/SUP], Reem F Bamogaddam[SUP] 12 [/SUP], Ashwaq H Alharthi[SUP] 17 [/SUP], Aisha Y Faqihi[SUP] 18 [/SUP], Bashayer F Alrumayyan[SUP] 18 [/SUP], Abeer Alshareef[SUP] 17 [/SUP], Batool M Alhassan[SUP] 19 [/SUP], Nader Y Damfu[SUP] 20 [/SUP], Ghada S Alajmi[SUP] 17 [/SUP], Asma Albujaidy[SUP] 21 [/SUP], Maram Alghalbi[SUP] 22 [/SUP], Saleh A Alajlan[SUP] 23 [/SUP], Ivo Abraham[SUP] 24 [/SUP], Abdulaziz S Almulhim[SUP] 25 [/SUP]
Affiliations
- PMID: 35209783
- DOI: 10.1080/14787210.2022.2046462
Abstract
Background: This study aimed to evaluate the effectiveness of tocilizumab in mechanically ventilated patients with coronavirus disease 2019 (COVID-19).
Research design and methods: This retrospective multicenter study included adults (≥18 years), diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by real-time polymerase chain reaction (RT-PCR) from nasopharyngeal swab, and requiring invasive mechanical ventilation during admission. Survival analyses with inverse propensity score treatment weighting (IPTW) and propensity score matching (PSM) were conducted. To account for immortal bias, we used Cox proportional modelling with time-dependent covariance. Competing risk analysis was performed for the extubation endpoint.
Results: A total of 556 (tocilizumab=193, control=363) patients were included. Males constituted the majority of the participants (69.2% in tocilizumab arm,74.1% in control arm). Tocilizumab was not associated with a reduction in mortality with hazard ratio (HR)=0.82 (95% confidence interval (CI: 0.62 to 1.10) in the Inverse propensity score weighting (IPTW) analysis and HR=0.86(95% CI: 0.64 to 1.16, P=0.349) in the PSM analysis. However, tocilizumab was associated with an increased rate of extubation (33.6%) compared to the control group (11.9%; subdistributional hazards (SHR)=3.1, 95% CI:1.86 to 5.16).
Conclusions: Although tocilizumab was not found to be effective in reducing mortality, extubation rate while on mechanical ventilation was higher among tocilizumab-treated group.
Keywords: COVID-19; Effectiveness; Mechanical ventilation; Mortality; Tocilizumab.