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Tocilizumab in patients hospitalized with COVID-19 pneumonia: systematic review and meta-analysis of randomized controlled trials.
J Investig Med. 2022 01; 70(1):55-60.JI

Abstract

Tocilizumab is an interleukin receptor inhibitor that has been used in patients with COVID-19 pneumonia. There are recent randomized controlled trials (RCTs) that evaluated the efficacy and safety of tocilizumab in hospitalized patients with COVID-19 pneumonia. We performed a systematic review and meta-analysis of RCTs that evaluated the effectiveness of tocilizumab in hospitalized patients with COVID-19 not requiring mechanical ventilation. RCTs comparing tocilizumab with the standard of care treatment in hospitalized patients with COVID-19 pneumonia not requiring mechanical ventilation at the time of administration were included for analysis. The primary outcome was a composite of mechanical ventilation or 28-day mortality and the secondary outcomes were 28-day mortality and major adverse events. A total of 6 RCTs were included for the analysis. Tocilizumab was associated with a statistically significant reduction in the primary composite outcome of mechanical ventilation or 28-day mortality (risk ratio (RR): 0.83 (95% CI: 0.74 to 0.92, I2=0, tau2=0). Treatment with tocilizumab did not show a statistically significant reduction in 28-day mortality (RR: 0.90 (95% CI: 0.76 to 1.07), I2=0, tau2=0) and rate of serious adverse events (RR: 0.82 (95% CI: 0.62 to 1.10), I2=0, tau2=0). Tocilizumab was associated with a decrease in the incidence of primary outcome, that is, mechanical ventilation or death at 28 days in hospitalized patients with COVID-19 pneumonia.

Authors+Show Affiliations

Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.Department of Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA.Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA.Department of Pulmonary Medicine and Critical Care, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.Department of Pulmonary Medicine and Critical Care, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA Brent-Brown@ouhsc.edu.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

34561232

Citation

Gupta, Samiksha, et al. "Tocilizumab in Patients Hospitalized With COVID-19 Pneumonia: Systematic Review and Meta-analysis of Randomized Controlled Trials." Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research, vol. 70, no. 1, 2022, pp. 55-60.
Gupta S, Padappayil RP, Bansal A, et al. Tocilizumab in patients hospitalized with COVID-19 pneumonia: systematic review and meta-analysis of randomized controlled trials. J Investig Med. 2022;70(1):55-60.
Gupta, S., Padappayil, R. P., Bansal, A., Daouk, S., & Brown, B. (2022). Tocilizumab in patients hospitalized with COVID-19 pneumonia: systematic review and meta-analysis of randomized controlled trials. Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research, 70(1), 55-60. https://doi.org/10.1136/jim-2021-002001
Gupta S, et al. Tocilizumab in Patients Hospitalized With COVID-19 Pneumonia: Systematic Review and Meta-analysis of Randomized Controlled Trials. J Investig Med. 2022;70(1):55-60. PubMed PMID: 34561232.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tocilizumab in patients hospitalized with COVID-19 pneumonia: systematic review and meta-analysis of randomized controlled trials. AU - Gupta,Samiksha, AU - Padappayil,Rana Prathap, AU - Bansal,Agam, AU - Daouk,Salim, AU - Brown,Brent, Y1 - 2021/09/24/ PY - 2021/07/27/accepted PY - 2021/9/26/pubmed PY - 2022/1/7/medline PY - 2021/9/25/entrez KW - COVID-19 KW - adult KW - anti-inflammatory agents KW - non-steroidal KW - pneumonia KW - respiratory distress syndrome SP - 55 EP - 60 JF - Journal of investigative medicine : the official publication of the American Federation for Clinical Research JO - J Investig Med VL - 70 IS - 1 N2 - Tocilizumab is an interleukin receptor inhibitor that has been used in patients with COVID-19 pneumonia. There are recent randomized controlled trials (RCTs) that evaluated the efficacy and safety of tocilizumab in hospitalized patients with COVID-19 pneumonia. We performed a systematic review and meta-analysis of RCTs that evaluated the effectiveness of tocilizumab in hospitalized patients with COVID-19 not requiring mechanical ventilation. RCTs comparing tocilizumab with the standard of care treatment in hospitalized patients with COVID-19 pneumonia not requiring mechanical ventilation at the time of administration were included for analysis. The primary outcome was a composite of mechanical ventilation or 28-day mortality and the secondary outcomes were 28-day mortality and major adverse events. A total of 6 RCTs were included for the analysis. Tocilizumab was associated with a statistically significant reduction in the primary composite outcome of mechanical ventilation or 28-day mortality (risk ratio (RR): 0.83 (95% CI: 0.74 to 0.92, I2=0, tau2=0). Treatment with tocilizumab did not show a statistically significant reduction in 28-day mortality (RR: 0.90 (95% CI: 0.76 to 1.07), I2=0, tau2=0) and rate of serious adverse events (RR: 0.82 (95% CI: 0.62 to 1.10), I2=0, tau2=0). Tocilizumab was associated with a decrease in the incidence of primary outcome, that is, mechanical ventilation or death at 28 days in hospitalized patients with COVID-19 pneumonia. SN - 1708-8267 UR - https://www.unboundmedicine.com/medline/citation/34561232/Tocilizumab_in_patients_hospitalized_with_COVID_19_pneumonia:_systematic_review_and_meta_analysis_of_randomized_controlled_trials_ L2 - https://jim.bmj.com/lookup/pmidlookup?view=long&pmid=34561232 DB - PRIME DP - Unbound Medicine ER -