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J Clin Pharm Ther . Tocilizumab use in patients with moderate to severe COVID-19: A retrospective cohort study

tetano

Editor, Senior Moderator
J Clin Pharm Ther


. 2020 Oct 24.
doi: 10.1111/jcpt.13303. Online ahead of print.
Tocilizumab use in patients with moderate to severe COVID-19: A retrospective cohort study


Sridhar Chilimuri[SUP] 1 [/SUP], Haozhe Sun[SUP] 1 [/SUP], Ahmed Alemam[SUP] 1 [/SUP], Kyoung-Sil Kang[SUP] 2 [/SUP], Peter Lao[SUP] 2 [/SUP], Nikhitha Mantri[SUP] 1 [/SUP], Lawrence Schiller[SUP] 2 [/SUP], Myroslava Sharabun[SUP] 2 [/SUP], Elona Shehi[SUP] 1 [/SUP], Jairo Tejada[SUP] 1 [/SUP], Alla Yugay[SUP] 1 [/SUP], Suresh Kumar Nayudu[SUP] 1 [/SUP]



Affiliations

Abstract

What is known and objective: The coronavirus disease 2019 (COVID-19) associated cytokine activation can lead to a rapid progression into respiratory failure, shock and multiorgan failure. Interleukin-6 (IL-6) is a pro-inflammatory cytokine that likely contributes to the pathogenesis of cytokine release syndrome. It is hypothesized that modulating IL-6 levels or its effects with tocilizumab, a recombinant humanized anti-IL-6 receptor monoclonal antibody, may alter the course of disease.
Methods: We examined the association between tocilizumab use and intubation or death at a community hospital in New York City. Data were obtained regarding consecutive patients hospitalized with COVID-19. The primary end point was a composite of intubation or death in a time-to-event analysis. We compared outcomes in patients who received tocilizumab with those in patients who did not, using a multivariable Cox model with inverse probability weighting according to the propensity score.
Results and discussion: In this single-centre retrospective cohort study involving 1225 hospitalized patients with SARS-CoV-2 infection, the probability to respiratory failure, which was measured as intubation or death, was less frequent in patients who received tocilizumab.
What is new and conclusion: Tocilizumab and other IL-6 receptor monoclonal antibodies may evolve as a viable option in treating patients with moderate and severe COVID-19.

Keywords: COVID-19; SARS-CoV-2; coronavirus; cytokine release syndrome; interleukin-6; tocilizumab.
 
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