Tags

Type your tag names separated by a space and hit enter

Tocilizumab in addition to standard of care in the management of COVID-19: a meta-analysis of RCTs.
Acta Biomed. 2022 03 14; 93(1):e2022014.AB

Abstract

OBJECTIVE

We performed a systematic review and meta-analysis for exploring clinical benefits and safety of tocilizumab in addition to standard of care (SOC) in treating patients with coronavirus disease 2019 (COVID-19).

METHODS

An electronic search was carried out in PubMed, EMBASE, Cochrane Library, and Science Direct, as well as in medRxiv preprint server, to identify eligible studies. Only randomized Controlled Trials (RCTs) that compared mortality events and/or adverse events between a tocilizumab + SOC group and a SOC-only control group were included. The primary outcome was 28-day mortality. Secondary outcomes include progression to severe disease, defined as need for mechanical ventilation (MV) or intensive care unit (ICU) admission, and adverse events (AE).

RESULTS

A total of nine studies (6,490 participants) could be included in this meta-analysis, with 3,358 participants in the tocilizumab + SOC group and 3,132 participants in the SOC-only group. The overall mortality rate was lower in the tocilizumab group compared to the SOC-only group, though the difference was not statistically significant (odds ratio [OR], 0.87; 95% CI, 0.73-1.04; I2, 15%). This finding was unaffected by subgroup analyses based on initial use of steroids or mechanical ventilation at baseline. Patients receiving tocilizumab were 26% less likely to progress to MV, and this difference was statistically significant (OR, 0.74; 95% CI, 0.64-0.86; I2, 0%). Among patients who were not in ICU at randomization, the tocilizumab group had 34 % lower rate of ICU admission compared to the SOC-only group (OR, 0.66; 95% CI, 0.40-2.14; I2, 29%). The occurrence of serious infections was lower in the tocilizumab group (OR, 0.57; 95% CI, 0.36-0.89; I2, 21%).

CONCLUSION

Tocilizumab is generally well-tolerated in COVID-19. Although this drug does not appear to have a significant benefits on survival, it may have a role in preventing progression to intensive care and MV.

Authors+Show Affiliations

School of Medicine. vicmutua3@gmail.com.. brandon.henry@cchmc.org.. csefalvayk@starschema.net.. isaacbmn@outlook.com.. jensvikse@gmail.com.. giuseppe.lippi@unvir.it.. nyamweya9083@gmail.com.. newnexmongare@gmail.com.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

35315395

Citation

Mutua, Victor, et al. "Tocilizumab in Addition to Standard of Care in the Management of COVID-19: a Meta-analysis of RCTs." Acta Bio-medica : Atenei Parmensis, vol. 93, no. 1, 2022, pp. e2022014.
Mutua V, Henry BM, Csefalvay CV, et al. Tocilizumab in addition to standard of care in the management of COVID-19: a meta-analysis of RCTs. Acta Biomed. 2022;93(1):e2022014.
Mutua, V., Henry, B. M., Csefalvay, C. V., Cheruiyot, I., Vikse, J., Lippi, G., Bundi, B., & Mong'are, N. (2022). Tocilizumab in addition to standard of care in the management of COVID-19: a meta-analysis of RCTs. Acta Bio-medica : Atenei Parmensis, 93(1), e2022014. https://doi.org/10.23750/abm.v93i1.12208
Mutua V, et al. Tocilizumab in Addition to Standard of Care in the Management of COVID-19: a Meta-analysis of RCTs. Acta Biomed. 2022 03 14;93(1):e2022014. PubMed PMID: 35315395.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tocilizumab in addition to standard of care in the management of COVID-19: a meta-analysis of RCTs. AU - Mutua,Victor, AU - Henry,Brandon Michael, AU - Csefalvay,Chris von, AU - Cheruiyot,Isaac, AU - Vikse,Jens, AU - Lippi,Giuseppe, AU - Bundi,Brian, AU - Mong'are,Newnex, Y1 - 2022/03/14/ PY - 2021/08/27/received PY - 2021/09/26/accepted PY - 2022/3/22/entrez PY - 2022/3/23/pubmed PY - 2022/3/25/medline SP - e2022014 EP - e2022014 JF - Acta bio-medica : Atenei Parmensis JO - Acta Biomed VL - 93 IS - 1 N2 - OBJECTIVE: We performed a systematic review and meta-analysis for exploring clinical benefits and safety of tocilizumab in addition to standard of care (SOC) in treating patients with coronavirus disease 2019 (COVID-19). METHODS: An electronic search was carried out in PubMed, EMBASE, Cochrane Library, and Science Direct, as well as in medRxiv preprint server, to identify eligible studies. Only randomized Controlled Trials (RCTs) that compared mortality events and/or adverse events between a tocilizumab + SOC group and a SOC-only control group were included. The primary outcome was 28-day mortality. Secondary outcomes include progression to severe disease, defined as need for mechanical ventilation (MV) or intensive care unit (ICU) admission, and adverse events (AE). RESULTS: A total of nine studies (6,490 participants) could be included in this meta-analysis, with 3,358 participants in the tocilizumab + SOC group and 3,132 participants in the SOC-only group. The overall mortality rate was lower in the tocilizumab group compared to the SOC-only group, though the difference was not statistically significant (odds ratio [OR], 0.87; 95% CI, 0.73-1.04; I2, 15%). This finding was unaffected by subgroup analyses based on initial use of steroids or mechanical ventilation at baseline. Patients receiving tocilizumab were 26% less likely to progress to MV, and this difference was statistically significant (OR, 0.74; 95% CI, 0.64-0.86; I2, 0%). Among patients who were not in ICU at randomization, the tocilizumab group had 34 % lower rate of ICU admission compared to the SOC-only group (OR, 0.66; 95% CI, 0.40-2.14; I2, 29%). The occurrence of serious infections was lower in the tocilizumab group (OR, 0.57; 95% CI, 0.36-0.89; I2, 21%). CONCLUSION: Tocilizumab is generally well-tolerated in COVID-19. Although this drug does not appear to have a significant benefits on survival, it may have a role in preventing progression to intensive care and MV. SN - 2531-6745 UR - https://www.unboundmedicine.com/medline/citation/35315395/Tocilizumab_in_addition_to_standard_of_care_in_the_management_of_COVID_19:_a_meta_analysis_of_RCTs_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/35315395/ DB - PRIME DP - Unbound Medicine ER -