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RESEARCH PRODUCT
Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review
V. GranoneAndrea CortegianiSharon EinavMaurizio CecconiAntonino GiarratanoCesare GregorettiMassimiliano GrecoAlessandro ProttiMariachiara Ippolitosubject
Coronavirus COVID-19 Pneumonia SARS-CoV-2 TocilizumabGCA Giant cell arteritispJIA Pediatric juvenile idiopathic arthritislaw.inventionchemistry.chemical_compound0302 clinical medicineRandomized controlled triallawMedicine030212 general & internal medicineClinical efficacyCPAP Continuous positive airway pressureCOVID-19 Coronavirus disease 2019IDSA Infectious Diseases Society of AmericaRA Rheumatoid arthritisTocilizumabIMV Invasive mechanical ventilationsJIA Juvenile idiopathic arthritisAIFA Agenzia Italiana del FarmacoPulmonary and Respiratory Medicinemedicine.medical_specialtyCoronavirus disease 2019 (COVID-19)Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)MEDLINEAntibodies Monoclonal HumanizedNIH U.S. National Institutes of HealthArticleWHO World Health OrganizationSIMIT Italian Society of Infectious and Tropical disease03 medical and health sciencesTocilizumabARDS Acute respiratory distress syndromeAnimalsHumansIn patientIntensive care medicineTocilizumab ; COVID-19 ; Pneumonia ; SARS-CoV-2 ; Coronaviruslcsh:RC705-779business.industryCRS CAR-T cell-induced cytokine release syndromeInterleukin-6SARS-CoV-2NIV Noninvasive mechanical ventilationTNF Tumor necrosis factorCOVID-19Pneumonialcsh:Diseases of the respiratory systemCOVID-19 Drug TreatmentClinical trialCoronavirus030228 respiratory systemchemistrybusinessICTRP International Clinical Trials Registry Platformdescription
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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-07-06 | Pulmonology |