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. 2021 Jan-Feb;27(1):52-66.
doi: 10.1016/j.pulmoe.2020.07.003. Epub 2020 Jul 20.

Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review

A Cortegiani  1 , M Ippolito  2 , M Greco  3 , V Granone  4 , A Protti  5 , C Gregoretti  6 , A Giarratano  7 , S Einav  8 , M Cecconi  9
Affiliations

Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review

A Cortegiani et al. Pulmonology. 2021 Jan-Feb.

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.

Keywords: COVID-19; Coronavirus; Pneumonia; SARS-CoV-2; Tocilizumab.

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Figures

Figure 1
Figure 1
PRISMA flow-chart. The figure shows the PRISMA flow-chart with inclusion/exclusion process in details.
Figure 2
Figure 2
Risk of bias of nonrandomized studies with comparison groups. The risk of bias of the included nonrandomized studies with comparison groups is reported per single study and per domain. RoB was assessed using Risk of Bias in Non-randomized Studies of Interventions, as appropriate.
See this image and copyright information in PMC

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References

    1. Sanders J.M., Monogue M.L., Jodlowski T.Z., Cutrell J.B. Pharmacologic treatments for coronavirus disease 2019 (COVID-19): a review. JAMA. 2020 doi: 10.1001/jama.2020.6019. - DOI - PubMed
    1. WHO. COVID-19 Situation report – 139. https://www.who.int/docs/default-source/coronaviruse/situation-reports/2.... 2020. [Accessed June 7, 2020].
    1. Johns Hopkins University & Medicine. Coronavirus resource center. https://coronavirus.jhu.edu/map.html. 2020. [Accessed June 7, 2020].
    1. Shi Y., Wang Y., Shao C., Huang J., Gan J., Xiaoping H., et al. COVID-19 infection: the perspectives on immune responses. Cell Death Differ. 2020;27:1451–1454. doi: 10.1038/s41418-020-0530-3. - DOI - PMC - PubMed
    1. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z., et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 doi: 10.1016/S0140-6736(20)30566-3. - DOI - PMC - PubMed

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