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

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...

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Detalles Bibliográficos
Autores principales: Cortegiani, A., Ippolito, M., Greco, M., Granone, V., Protti, A., Gregoretti, C., Giarratano, A., Einav, S., Cecconi, M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. 2021
Materias:
Review
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369580/
https://www.ncbi.nlm.nih.gov/pubmed/32713784
http://dx.doi.org/10.1016/j.pulmoe.2020.07.003
Descripción
Sumario: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.

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