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No evidence of tocilizumab treatment efficacy for severe to critical SARS-CoV2 infected patients: Results from a retrospective controlled multicenter study

To assess tocilizumab (TCZ) efficacy associated to standard of care (SOC) compared to SOC alone in severe coronavirus associated disease 2019 (COVID-19) patients. In a matched case-control study from 3 French Hospital COVID-19 Departments, 27 patients with severe COVID-19 treated with TCZ and SOC we...

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Autores principales: Burlacu, Ruxandra, London, Jonathan, Fleury, Audrey, Sené, Thomas, Diallo, Abdourahmane, Meyssonnier, Vanina, Zeller, Valérie, Galland, Joris, Huscenot, Tessa, Rubenstein, Emma, Trouiller, Pierre, Amathieu, Roland, Kutter, Johannes, Blondeel, David, Lejour, Gabriel, Mouly, Stéphane, Lidove, Olivier, Wladimir, Mauhin, Sène, Damien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8154429/
https://www.ncbi.nlm.nih.gov/pubmed/34032722
http://dx.doi.org/10.1097/MD.0000000000026023
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author Burlacu, Ruxandra
London, Jonathan
Fleury, Audrey
Sené, Thomas
Diallo, Abdourahmane
Meyssonnier, Vanina
Zeller, Valérie
Galland, Joris
Huscenot, Tessa
Rubenstein, Emma
Trouiller, Pierre
Amathieu, Roland
Kutter, Johannes
Blondeel, David
Lejour, Gabriel
Mouly, Stéphane
Lidove, Olivier
Wladimir, Mauhin
Sène, Damien
author_facet Burlacu, Ruxandra
London, Jonathan
Fleury, Audrey
Sené, Thomas
Diallo, Abdourahmane
Meyssonnier, Vanina
Zeller, Valérie
Galland, Joris
Huscenot, Tessa
Rubenstein, Emma
Trouiller, Pierre
Amathieu, Roland
Kutter, Johannes
Blondeel, David
Lejour, Gabriel
Mouly, Stéphane
Lidove, Olivier
Wladimir, Mauhin
Sène, Damien
author_sort Burlacu, Ruxandra
collection PubMed
description To assess tocilizumab (TCZ) efficacy associated to standard of care (SOC) compared to SOC alone in severe coronavirus associated disease 2019 (COVID-19) patients. In a matched case-control study from 3 French Hospital COVID-19 Departments, 27 patients with severe COVID-19 treated with TCZ and SOC were matched for baseline epidemiological and clinical features and compared to 27 severe COVID-19 patients treated with SOC alone. Baseline characteristics of the study population were comparable between groups. Eleven patients (20%) died. TCZ was not associated with clinical improvement as compared to SOC regarding oxygen-free status (44% vs 63%) and death (18.5% vs 22%), despite a higher decrease of the C-reactive protein at Day 7 (10.7 vs 52 mg/L; P < 10(−3)). Compared to the 43 patients alive at the end-of follow-up, patients who died were older (78 vs 64 years; P < 10(−3)), with 82% of them older than 72 years vs only 23% of live patients (P < 10(−3)). Age (OR = 1.15; 95%CI = 1.04–1.3; P = .008) and age over 72 years (OR) = 14.85; 95%CI = 2.7–80; P = .002) were independently associated with mortality. TCZ in addition to SOC for severe COVID-19 patients did not reduce mortality, subsequent need for invasive mechanical ventilation nor did it shorten the time of oxygen support, despite better control of the inflammatory response. More powerful and randomized controlled trials are warranted to determine if TCZ is effective in the management of COVID-19.
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spelling pubmed-81544292021-05-29 No evidence of tocilizumab treatment efficacy for severe to critical SARS-CoV2 infected patients: Results from a retrospective controlled multicenter study Burlacu, Ruxandra London, Jonathan Fleury, Audrey Sené, Thomas Diallo, Abdourahmane Meyssonnier, Vanina Zeller, Valérie Galland, Joris Huscenot, Tessa Rubenstein, Emma Trouiller, Pierre Amathieu, Roland Kutter, Johannes Blondeel, David Lejour, Gabriel Mouly, Stéphane Lidove, Olivier Wladimir, Mauhin Sène, Damien Medicine (Baltimore) 4900 To assess tocilizumab (TCZ) efficacy associated to standard of care (SOC) compared to SOC alone in severe coronavirus associated disease 2019 (COVID-19) patients. In a matched case-control study from 3 French Hospital COVID-19 Departments, 27 patients with severe COVID-19 treated with TCZ and SOC were matched for baseline epidemiological and clinical features and compared to 27 severe COVID-19 patients treated with SOC alone. Baseline characteristics of the study population were comparable between groups. Eleven patients (20%) died. TCZ was not associated with clinical improvement as compared to SOC regarding oxygen-free status (44% vs 63%) and death (18.5% vs 22%), despite a higher decrease of the C-reactive protein at Day 7 (10.7 vs 52 mg/L; P < 10(−3)). Compared to the 43 patients alive at the end-of follow-up, patients who died were older (78 vs 64 years; P < 10(−3)), with 82% of them older than 72 years vs only 23% of live patients (P < 10(−3)). Age (OR = 1.15; 95%CI = 1.04–1.3; P = .008) and age over 72 years (OR) = 14.85; 95%CI = 2.7–80; P = .002) were independently associated with mortality. TCZ in addition to SOC for severe COVID-19 patients did not reduce mortality, subsequent need for invasive mechanical ventilation nor did it shorten the time of oxygen support, despite better control of the inflammatory response. More powerful and randomized controlled trials are warranted to determine if TCZ is effective in the management of COVID-19. Lippincott Williams & Wilkins 2021-05-28 /pmc/articles/PMC8154429/ /pubmed/34032722 http://dx.doi.org/10.1097/MD.0000000000026023 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.
spellingShingle 4900
Burlacu, Ruxandra
London, Jonathan
Fleury, Audrey
Sené, Thomas
Diallo, Abdourahmane
Meyssonnier, Vanina
Zeller, Valérie
Galland, Joris
Huscenot, Tessa
Rubenstein, Emma
Trouiller, Pierre
Amathieu, Roland
Kutter, Johannes
Blondeel, David
Lejour, Gabriel
Mouly, Stéphane
Lidove, Olivier
Wladimir, Mauhin
Sène, Damien
No evidence of tocilizumab treatment efficacy for severe to critical SARS-CoV2 infected patients: Results from a retrospective controlled multicenter study
title No evidence of tocilizumab treatment efficacy for severe to critical SARS-CoV2 infected patients: Results from a retrospective controlled multicenter study
title_full No evidence of tocilizumab treatment efficacy for severe to critical SARS-CoV2 infected patients: Results from a retrospective controlled multicenter study
title_fullStr No evidence of tocilizumab treatment efficacy for severe to critical SARS-CoV2 infected patients: Results from a retrospective controlled multicenter study
title_full_unstemmed No evidence of tocilizumab treatment efficacy for severe to critical SARS-CoV2 infected patients: Results from a retrospective controlled multicenter study
title_short No evidence of tocilizumab treatment efficacy for severe to critical SARS-CoV2 infected patients: Results from a retrospective controlled multicenter study
title_sort no evidence of tocilizumab treatment efficacy for severe to critical sars-cov2 infected patients: results from a retrospective controlled multicenter study
topic 4900
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8154429/
https://www.ncbi.nlm.nih.gov/pubmed/34032722
http://dx.doi.org/10.1097/MD.0000000000026023
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