Cargando…

Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia

INTRODUCTION: Tocilizumab (TCZ) is an interleukin-6 receptor antagonist, which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), which aims to ameliorate the cytokine release syndrome (CRS) induced acute respiratory distress syndrome (ARDS). However, there are no consistent data...

Descripción completa

Detalles Bibliográficos
Autores principales: Górgolas Hernández-Mora, Miguel, Cabello Úbeda, Alfonso, Prieto-Pérez, Laura, Villar Álvarez, Felipe, Álvarez Álvarez, Beatriz, Rodríguez Nieto, María Jesús, Carrillo Acosta, Irene, Fernández Ormaechea, Itziar, Al-Hayani, Aws Waleed Mohammed, Carballosa, Pilar, Calpena Martínez, Silvia, Ezzine, Farah, Castellanos González, Marina, Naya, Alba, López De Las Heras, Marta, Rodríguez Guzmán, Marcel José, Cordero Guijarro, Ana, Broncano Lavado, Antonio, Macías Valcayo, Alicia, Martín García, Marta, Bécares Martínez, Javier, Fernández Roblas, Ricardo, Piris Pinilla, Miguel Ángel, Fortes Alen, José, Sánchez Pernaute, Olga, Romero Bueno, Fredeswinda, Heili-Frades, Sarah, Peces-Barba Romero, Germán
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585732/
https://www.ncbi.nlm.nih.gov/pubmed/33115682
http://dx.doi.org/10.1016/j.ijid.2020.10.045
_version_ 1783599850954162176
author Górgolas Hernández-Mora, Miguel
Cabello Úbeda, Alfonso
Prieto-Pérez, Laura
Villar Álvarez, Felipe
Álvarez Álvarez, Beatriz
Rodríguez Nieto, María Jesús
Carrillo Acosta, Irene
Fernández Ormaechea, Itziar
Al-Hayani, Aws Waleed Mohammed
Carballosa, Pilar
Calpena Martínez, Silvia
Ezzine, Farah
Castellanos González, Marina
Naya, Alba
López De Las Heras, Marta
Rodríguez Guzmán, Marcel José
Cordero Guijarro, Ana
Broncano Lavado, Antonio
Macías Valcayo, Alicia
Martín García, Marta
Bécares Martínez, Javier
Fernández Roblas, Ricardo
Piris Pinilla, Miguel Ángel
Fortes Alen, José
Sánchez Pernaute, Olga
Romero Bueno, Fredeswinda
Heili-Frades, Sarah
Peces-Barba Romero, Germán
author_facet Górgolas Hernández-Mora, Miguel
Cabello Úbeda, Alfonso
Prieto-Pérez, Laura
Villar Álvarez, Felipe
Álvarez Álvarez, Beatriz
Rodríguez Nieto, María Jesús
Carrillo Acosta, Irene
Fernández Ormaechea, Itziar
Al-Hayani, Aws Waleed Mohammed
Carballosa, Pilar
Calpena Martínez, Silvia
Ezzine, Farah
Castellanos González, Marina
Naya, Alba
López De Las Heras, Marta
Rodríguez Guzmán, Marcel José
Cordero Guijarro, Ana
Broncano Lavado, Antonio
Macías Valcayo, Alicia
Martín García, Marta
Bécares Martínez, Javier
Fernández Roblas, Ricardo
Piris Pinilla, Miguel Ángel
Fortes Alen, José
Sánchez Pernaute, Olga
Romero Bueno, Fredeswinda
Heili-Frades, Sarah
Peces-Barba Romero, Germán
author_sort Górgolas Hernández-Mora, Miguel
collection PubMed
description INTRODUCTION: Tocilizumab (TCZ) is an interleukin-6 receptor antagonist, which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), which aims to ameliorate the cytokine release syndrome (CRS) induced acute respiratory distress syndrome (ARDS). However, there are no consistent data about who might benefit most from it. METHODS: We administered TCZ on a compassionate-use basis to patients with SSP who were hospitalized (excluding intensive care and intubated cases) and who required oxygen support to have a saturation >93%. The primary endpoint was intubation or death after 24 h of its administration. Patients received at least one dose of 400 mg intravenous TCZ from March 8, 2020 to April 20, 2020. RESULTS: A total of 207 patients were studied and 186 analyzed. The mean age was 65 years and 68% were male patients. A coexisting condition was present in 68% of cases. Prognostic factors of death were older age, higher IL-6, d-dimer and high-sensitivity C-reactive protein (HSCRP), lower total lymphocytes, and severe disease that requires additional oxygen support. The primary endpoint (intubation or death) was significantly worst (37% vs 13%, p < 0·001) in those receiving the drug when the oxygen support was high (FiO2 >0.5%). CONCLUSIONS: TCZ is well tolerated in patients with SSP, but it has a limited effect on the evolution of cases with high oxygen support needs.
format Online
Article
Text
id pubmed-7585732
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
record_format MEDLINE/PubMed
spelling pubmed-75857322020-10-26 Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia Górgolas Hernández-Mora, Miguel Cabello Úbeda, Alfonso Prieto-Pérez, Laura Villar Álvarez, Felipe Álvarez Álvarez, Beatriz Rodríguez Nieto, María Jesús Carrillo Acosta, Irene Fernández Ormaechea, Itziar Al-Hayani, Aws Waleed Mohammed Carballosa, Pilar Calpena Martínez, Silvia Ezzine, Farah Castellanos González, Marina Naya, Alba López De Las Heras, Marta Rodríguez Guzmán, Marcel José Cordero Guijarro, Ana Broncano Lavado, Antonio Macías Valcayo, Alicia Martín García, Marta Bécares Martínez, Javier Fernández Roblas, Ricardo Piris Pinilla, Miguel Ángel Fortes Alen, José Sánchez Pernaute, Olga Romero Bueno, Fredeswinda Heili-Frades, Sarah Peces-Barba Romero, Germán Int J Infect Dis Article INTRODUCTION: Tocilizumab (TCZ) is an interleukin-6 receptor antagonist, which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), which aims to ameliorate the cytokine release syndrome (CRS) induced acute respiratory distress syndrome (ARDS). However, there are no consistent data about who might benefit most from it. METHODS: We administered TCZ on a compassionate-use basis to patients with SSP who were hospitalized (excluding intensive care and intubated cases) and who required oxygen support to have a saturation >93%. The primary endpoint was intubation or death after 24 h of its administration. Patients received at least one dose of 400 mg intravenous TCZ from March 8, 2020 to April 20, 2020. RESULTS: A total of 207 patients were studied and 186 analyzed. The mean age was 65 years and 68% were male patients. A coexisting condition was present in 68% of cases. Prognostic factors of death were older age, higher IL-6, d-dimer and high-sensitivity C-reactive protein (HSCRP), lower total lymphocytes, and severe disease that requires additional oxygen support. The primary endpoint (intubation or death) was significantly worst (37% vs 13%, p < 0·001) in those receiving the drug when the oxygen support was high (FiO2 >0.5%). CONCLUSIONS: TCZ is well tolerated in patients with SSP, but it has a limited effect on the evolution of cases with high oxygen support needs. The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2021-01 2020-10-25 /pmc/articles/PMC7585732/ /pubmed/33115682 http://dx.doi.org/10.1016/j.ijid.2020.10.045 Text en © 2020 The Authors Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Górgolas Hernández-Mora, Miguel
Cabello Úbeda, Alfonso
Prieto-Pérez, Laura
Villar Álvarez, Felipe
Álvarez Álvarez, Beatriz
Rodríguez Nieto, María Jesús
Carrillo Acosta, Irene
Fernández Ormaechea, Itziar
Al-Hayani, Aws Waleed Mohammed
Carballosa, Pilar
Calpena Martínez, Silvia
Ezzine, Farah
Castellanos González, Marina
Naya, Alba
López De Las Heras, Marta
Rodríguez Guzmán, Marcel José
Cordero Guijarro, Ana
Broncano Lavado, Antonio
Macías Valcayo, Alicia
Martín García, Marta
Bécares Martínez, Javier
Fernández Roblas, Ricardo
Piris Pinilla, Miguel Ángel
Fortes Alen, José
Sánchez Pernaute, Olga
Romero Bueno, Fredeswinda
Heili-Frades, Sarah
Peces-Barba Romero, Germán
Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
title Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
title_full Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
title_fullStr Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
title_full_unstemmed Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
title_short Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
title_sort compassionate use of tocilizumab in severe sars-cov2 pneumonia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585732/
https://www.ncbi.nlm.nih.gov/pubmed/33115682
http://dx.doi.org/10.1016/j.ijid.2020.10.045
work_keys_str_mv AT gorgolashernandezmoramiguel compassionateuseoftocilizumabinseveresarscov2pneumonia
AT cabelloubedaalfonso compassionateuseoftocilizumabinseveresarscov2pneumonia
AT prietoperezlaura compassionateuseoftocilizumabinseveresarscov2pneumonia
AT villaralvarezfelipe compassionateuseoftocilizumabinseveresarscov2pneumonia
AT alvarezalvarezbeatriz compassionateuseoftocilizumabinseveresarscov2pneumonia
AT rodrigueznietomariajesus compassionateuseoftocilizumabinseveresarscov2pneumonia
AT carrilloacostairene compassionateuseoftocilizumabinseveresarscov2pneumonia
AT fernandezormaecheaitziar compassionateuseoftocilizumabinseveresarscov2pneumonia
AT alhayaniawswaleedmohammed compassionateuseoftocilizumabinseveresarscov2pneumonia
AT carballosapilar compassionateuseoftocilizumabinseveresarscov2pneumonia
AT calpenamartinezsilvia compassionateuseoftocilizumabinseveresarscov2pneumonia
AT ezzinefarah compassionateuseoftocilizumabinseveresarscov2pneumonia
AT castellanosgonzalezmarina compassionateuseoftocilizumabinseveresarscov2pneumonia
AT nayaalba compassionateuseoftocilizumabinseveresarscov2pneumonia
AT lopezdelasherasmarta compassionateuseoftocilizumabinseveresarscov2pneumonia
AT rodriguezguzmanmarceljose compassionateuseoftocilizumabinseveresarscov2pneumonia
AT corderoguijarroana compassionateuseoftocilizumabinseveresarscov2pneumonia
AT broncanolavadoantonio compassionateuseoftocilizumabinseveresarscov2pneumonia
AT maciasvalcayoalicia compassionateuseoftocilizumabinseveresarscov2pneumonia
AT martingarciamarta compassionateuseoftocilizumabinseveresarscov2pneumonia
AT becaresmartinezjavier compassionateuseoftocilizumabinseveresarscov2pneumonia
AT fernandezroblasricardo compassionateuseoftocilizumabinseveresarscov2pneumonia
AT pirispinillamiguelangel compassionateuseoftocilizumabinseveresarscov2pneumonia
AT fortesalenjose compassionateuseoftocilizumabinseveresarscov2pneumonia
AT sanchezpernauteolga compassionateuseoftocilizumabinseveresarscov2pneumonia
AT romerobuenofredeswinda compassionateuseoftocilizumabinseveresarscov2pneumonia
AT heilifradessarah compassionateuseoftocilizumabinseveresarscov2pneumonia
AT pecesbarbaromerogerman compassionateuseoftocilizumabinseveresarscov2pneumonia