Tags

Type your tag names separated by a space and hit enter

Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review.
Pulmonology. 2021 Jan-Feb; 27(1):52-66.P

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.

Authors+Show Affiliations

Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo. Department of Anesthesia Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy. Electronic address: andrea.cortegiani@unipa.it.Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo. Department of Anesthesia Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy. Electronic address: ippolito.mariachiara@gmail.com.Department of Anesthesiology and Intensive Care, Humanitas Clinical and Research Center - IRCCS, Milan, Italy; Department of Biomedical Science, Humanitas University, Milan, Italy. Electronic address: massimiliano.greco@hunimed.eu.Department of Anesthesiology and Intensive Care, Humanitas Clinical and Research Center - IRCCS, Milan, Italy; Department of Biomedical Science, Humanitas University, Milan, Italy. Electronic address: veronica.granone@gmail.com.Department of Anesthesiology and Intensive Care, Humanitas Clinical and Research Center - IRCCS, Milan, Italy; Department of Biomedical Science, Humanitas University, Milan, Italy. Electronic address: alessandro.protti@hunimed.eu.Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo. Department of Anesthesia Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy; Fondazione "Giglio", Cefalù, Italy. Electronic address: c.gregoretti@gmail.com.Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo. Department of Anesthesia Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy. Electronic address: antonino.giarratano@unipa.it.IntensiveCare Unit of the Shaare Zedek Medical Medical Centre and Hebrew University Faculty of Medicine, Jerusalem, Israel. Electronic address: einav_s@szmc.org.il.Department of Anesthesiology and Intensive Care, Humanitas Clinical and Research Center - IRCCS, Milan, Italy; Department of Biomedical Science, Humanitas University, Milan, Italy. Electronic address: maurizio.cecconi@hunimed.eu.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

32713784

Citation

Cortegiani, A, et al. "Rationale and Evidence On the Use of Tocilizumab in COVID-19: a Systematic Review." Pulmonology, vol. 27, no. 1, 2021, pp. 52-66.
Cortegiani A, Ippolito M, Greco M, et al. Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review. Pulmonology. 2021;27(1):52-66.
Cortegiani, A., Ippolito, M., Greco, M., Granone, V., Protti, A., Gregoretti, C., Giarratano, A., Einav, S., & Cecconi, M. (2021). Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review. Pulmonology, 27(1), 52-66. https://doi.org/10.1016/j.pulmoe.2020.07.003
Cortegiani A, et al. Rationale and Evidence On the Use of Tocilizumab in COVID-19: a Systematic Review. Pulmonology. 2021 Jan-Feb;27(1):52-66. PubMed PMID: 32713784.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review. AU - Cortegiani,A, AU - Ippolito,M, AU - Greco,M, AU - Granone,V, AU - Protti,A, AU - Gregoretti,C, AU - Giarratano,A, AU - Einav,S, AU - Cecconi,M, Y1 - 2020/07/20/ PY - 2020/07/06/received PY - 2020/07/07/accepted PY - 2020/7/28/pubmed PY - 2021/1/13/medline PY - 2020/7/28/entrez KW - COVID-19 KW - Coronavirus KW - Pneumonia KW - SARS-CoV-2 KW - Tocilizumab SP - 52 EP - 66 JF - Pulmonology JO - Pulmonology VL - 27 IS - 1 N2 - 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. SN - 2531-0437 UR - https://www.unboundmedicine.com/medline/citation/32713784/Rationale_and_evidence_on_the_use_of_tocilizumab_in_COVID_19:_a_systematic_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2531-0437(20)30153-7 DB - PRIME DP - Unbound Medicine ER -