tetano
Editor, Senior Moderator
J Med Virol
. 2020 Sep 12.
doi: 10.1002/jmv.26509. Online ahead of print.
Efficacy of Tocilizumab in COVID-19: A Systematic review and Meta-Analysis
Muhammad Aziz[SUP] 1 [/SUP], Hossein Haghbin[SUP] 2 [/SUP], Emad Abu Sitta[SUP] 3 [/SUP], Yusuf Nawras[SUP] 2 [/SUP], Rawish Fatima[SUP] 2 [/SUP], Sachit Sharma[SUP] 2 [/SUP], Wade Lee-Smith[SUP] 4 [/SUP], Joan Duggan[SUP] 3 [/SUP], Joel A Kammeyer[SUP] 3 [/SUP], Jennifer Hanarahan[SUP] 3 [/SUP], Ragheb Assaly[SUP] 5 [/SUP]
Affiliations
Abstract
Introduction: The efficacy of tocilizumab (TOC), monoclonal antibody against Interleukin-6 (IL-6) receptor, in patients with Coronavirus disease-2019 (COVID-19) patients has led to conflicting results. We performed a systematic review and meta-analysis to compare the efficacy of addition of TOC to standard of care (SOC) versus SOC in patients with COVID-19.
Methods: We performed a comprehensive literature search of PubMed, Embase, Web of Science, WHO COVID, LitCOVID and Cochrane databases. Pooled outcomes (overall mortality, need for mechanical ventilation, intensive care unit (ICU) admission, and secondary infections) were compared using DerSimonian-Laird/Random-effects approach. Risk difference (RD), confidence interval (CI), and p-values were generated.
Results: A total of 23 studies with 6279 patients (1897 in TOC and 4382 in SOC group, respectively) were included. The overall mortality was lower in TOC group compared to SOC group (RD: -0.06, CI: -0.12 - -0.01, p = 0.03). Subgroup analysis including studies with only severe cases revealed lower mortality (RD: -0.12, CI: -0.18 - -0.06, p <0.01) and need for mechanical ventilation (RD: -0.11, CI: -0.19 - -0.02, p = 0.01) in TOC group compared to SOC group.
Conclusion: The addition of TOC to SOC has the potential to reduce mortality and need for mechanical ventilation in patients with severe COVID-19. Randomized controlled trials are needed to validate this. This article is protected by copyright. All rights reserved.
. 2020 Sep 12.
doi: 10.1002/jmv.26509. Online ahead of print.
Efficacy of Tocilizumab in COVID-19: A Systematic review and Meta-Analysis
Muhammad Aziz[SUP] 1 [/SUP], Hossein Haghbin[SUP] 2 [/SUP], Emad Abu Sitta[SUP] 3 [/SUP], Yusuf Nawras[SUP] 2 [/SUP], Rawish Fatima[SUP] 2 [/SUP], Sachit Sharma[SUP] 2 [/SUP], Wade Lee-Smith[SUP] 4 [/SUP], Joan Duggan[SUP] 3 [/SUP], Joel A Kammeyer[SUP] 3 [/SUP], Jennifer Hanarahan[SUP] 3 [/SUP], Ragheb Assaly[SUP] 5 [/SUP]
Affiliations
- PMID: 32918755
- DOI: 10.1002/jmv.26509
Abstract
Introduction: The efficacy of tocilizumab (TOC), monoclonal antibody against Interleukin-6 (IL-6) receptor, in patients with Coronavirus disease-2019 (COVID-19) patients has led to conflicting results. We performed a systematic review and meta-analysis to compare the efficacy of addition of TOC to standard of care (SOC) versus SOC in patients with COVID-19.
Methods: We performed a comprehensive literature search of PubMed, Embase, Web of Science, WHO COVID, LitCOVID and Cochrane databases. Pooled outcomes (overall mortality, need for mechanical ventilation, intensive care unit (ICU) admission, and secondary infections) were compared using DerSimonian-Laird/Random-effects approach. Risk difference (RD), confidence interval (CI), and p-values were generated.
Results: A total of 23 studies with 6279 patients (1897 in TOC and 4382 in SOC group, respectively) were included. The overall mortality was lower in TOC group compared to SOC group (RD: -0.06, CI: -0.12 - -0.01, p = 0.03). Subgroup analysis including studies with only severe cases revealed lower mortality (RD: -0.12, CI: -0.18 - -0.06, p <0.01) and need for mechanical ventilation (RD: -0.11, CI: -0.19 - -0.02, p = 0.01) in TOC group compared to SOC group.
Conclusion: The addition of TOC to SOC has the potential to reduce mortality and need for mechanical ventilation in patients with severe COVID-19. Randomized controlled trials are needed to validate this. This article is protected by copyright. All rights reserved.