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Association between tocilizumab treatment and clinical outcomes of COVID-19 patients: a systematic review and meta-analysis.
Aging (Albany NY). 2022 01 17; 14(2):557-571.A

Abstract

To explore and summarize the association between treatment with tocilizumab and clinical outcomes in COVID-19 patients. We performed a systematic review and meta-analysis (10 RCTs including 3378 patients in the tocilizumab group and 3142 patients in the control group). We systematically searched PubMed and MedRxiv for all RCTs as of June 1, 2021, to assess the benefits and harms of tocilizumab to treat patients with COVID-19. All analyses were carried out using RevMan version 5.4.1. There were nine RCTs published in peer-reviewed journals and one RCTs published as a preprint. The summary RR for all-cause mortality with tocilizumab was 0.89 (95% CI= 0.82-0.96, P= 0.003). There was no significant between-trial heterogeneity (I2= 28%, P= 0.19). However, all peer-reviewed RCTs showed no significant associations between treatment with tocilizumab and reductions in all-cause mortality. We notably found that tocilizumab significantly reduced the rate of intubation or death in patients with COVID-19 with 3 RCTs. Across the 8 RCTs, the summary RR for discharge with tocilizumab was 1.10 (95% CI= 1.03-1.16, P< 0.00001). There was no significant association of tocilizumab with harm on other patient-relevant clinical outcomes, including increasing secondary infection risk, patients of adverse events, or patients of serious adverse events. Tocilizumab significantly increased the rate of hospital discharges in COVID-19 patients. Still, it did not decrease all-cause mortality or increase the risk of secondary infections, patients of adverse events, or patients for serious adverse events. Evidence that tocilizumab affects clinical outcomes in patients with COVID-19 requires further proof.

Authors+Show Affiliations

Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing 210042, Jiangsu, People's Republic of China. Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing 210042, Jiangsu, People's Republic of China.Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing 210042, Jiangsu, People's Republic of China. Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing 210042, Jiangsu, People's Republic of China.Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing 210042, Jiangsu, People's Republic of China. Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing 210042, Jiangsu, People's Republic of China.Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing 210042, Jiangsu, People's Republic of China. Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing 210042, Jiangsu, People's Republic of China.Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing 210042, Jiangsu, People's Republic of China. Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing 210042, Jiangsu, People's Republic of China.Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing 210042, Jiangsu, People's Republic of China. Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing 210042, Jiangsu, People's Republic of China.Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing 210042, Jiangsu, People's Republic of China. Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing 210042, Jiangsu, People's Republic of China.Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing 210042, Jiangsu, People's Republic of China. Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, People's Republic of China. Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing 210042, Jiangsu, People's Republic of China.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

35038318

Citation

Peng, Jingwen, et al. "Association Between Tocilizumab Treatment and Clinical Outcomes of COVID-19 Patients: a Systematic Review and Meta-analysis." Aging, vol. 14, no. 2, 2022, pp. 557-571.
Peng J, She X, Mei H, et al. Association between tocilizumab treatment and clinical outcomes of COVID-19 patients: a systematic review and meta-analysis. Aging (Albany NY). 2022;14(2):557-571.
Peng, J., She, X., Mei, H., Zheng, H., Fu, M., Liang, G., Wang, Q., & Liu, W. (2022). Association between tocilizumab treatment and clinical outcomes of COVID-19 patients: a systematic review and meta-analysis. Aging, 14(2), 557-571. https://doi.org/10.18632/aging.203834
Peng J, et al. Association Between Tocilizumab Treatment and Clinical Outcomes of COVID-19 Patients: a Systematic Review and Meta-analysis. Aging (Albany NY). 2022 01 17;14(2):557-571. PubMed PMID: 35038318.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between tocilizumab treatment and clinical outcomes of COVID-19 patients: a systematic review and meta-analysis. AU - Peng,Jingwen, AU - She,Xiaodong, AU - Mei,Huan, AU - Zheng,Hailin, AU - Fu,Meihua, AU - Liang,Guanzhao, AU - Wang,Qiong, AU - Liu,Weida, Y1 - 2022/01/17/ PY - 2021/07/23/received PY - 2021/12/29/accepted PY - 2022/1/18/pubmed PY - 2022/2/25/medline PY - 2022/1/17/entrez KW - COVID-19 KW - efficacy KW - meta-analysis KW - randomized controlled trial KW - tocilizumab SP - 557 EP - 571 JF - Aging JO - Aging (Albany NY) VL - 14 IS - 2 N2 - To explore and summarize the association between treatment with tocilizumab and clinical outcomes in COVID-19 patients. We performed a systematic review and meta-analysis (10 RCTs including 3378 patients in the tocilizumab group and 3142 patients in the control group). We systematically searched PubMed and MedRxiv for all RCTs as of June 1, 2021, to assess the benefits and harms of tocilizumab to treat patients with COVID-19. All analyses were carried out using RevMan version 5.4.1. There were nine RCTs published in peer-reviewed journals and one RCTs published as a preprint. The summary RR for all-cause mortality with tocilizumab was 0.89 (95% CI= 0.82-0.96, P= 0.003). There was no significant between-trial heterogeneity (I2= 28%, P= 0.19). However, all peer-reviewed RCTs showed no significant associations between treatment with tocilizumab and reductions in all-cause mortality. We notably found that tocilizumab significantly reduced the rate of intubation or death in patients with COVID-19 with 3 RCTs. Across the 8 RCTs, the summary RR for discharge with tocilizumab was 1.10 (95% CI= 1.03-1.16, P< 0.00001). There was no significant association of tocilizumab with harm on other patient-relevant clinical outcomes, including increasing secondary infection risk, patients of adverse events, or patients of serious adverse events. Tocilizumab significantly increased the rate of hospital discharges in COVID-19 patients. Still, it did not decrease all-cause mortality or increase the risk of secondary infections, patients of adverse events, or patients for serious adverse events. Evidence that tocilizumab affects clinical outcomes in patients with COVID-19 requires further proof. SN - 1945-4589 UR - https://www.unboundmedicine.com/medline/citation/35038318/Association_between_tocilizumab_treatment_and_clinical_outcomes_of_COVID_19_patients:_a_systematic_review_and_meta_analysis_ L2 - https://www.impactaging.com/full/14/557 DB - PRIME DP - Unbound Medicine ER -