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The new coronavirus disease may be related to immune response imbalance and excessive inflammation, which can cause or exacerbate acute respiratory distress syndrome (ARDS) and multiple organ failure
.
However, the clinical efficacy and safety of tocilizumab in the treatment of patients with new coronary pneumonia have always been controversial
.
Epidemiological studies and recent retrospective studies have shown that circulating interleukin 6 (IL-6), IL-1Ra, IL-1b, IL-10, IL-17, IL- 18.
Interferon c (IFN-c), tumor necrosis factor a (TNF-a), c-reactive protein (CRP), granulocyte colony stimulating factor (G-CSF) and macrophage colony stimulating factor (M-CSF) , Suggesting the rapid activation of the innate immune response
.
Multiple studies have shown that increased plasma IL-6 levels in COVID-19 patients in the intensive care unit seem to be positively correlated with mortality
.
In an observational study, the anti-IL-6 receptor monoclonal antibody tocilizumab has been approved for the treatment of a variety of inflammatory diseases and appears to improve the prognosis of COVID-19 patients in several countries
.
Some recent studies have shown that tocilizumab may be closely related to the low risk of intubation or death in severe and critically ill patients with COVID-19 pneumonia
.
Since the clinical severity of COVID-19 patients seems to be related to the cytokine storm and the excessive production of soluble inflammatory mediators, the current research results on the efficacy of tocilizumab in the treatment of COVID-19 patients are inconsistent
.
On July 10, 2021, Professor Xia Xinyi’s team from Jinling Hospital Affiliated to Nanjing University School of Medicine (Eastern Theater General Hospital) published a titled “Efficacy and Safety of Tocilizumab Treatment COVID-19 Patients: A Case-” in the journal Infectious Diseases and Therapy.
Control Study and Meta-Analysis paper
.
In this study, 190 COVID-19 patients were analyzed.
Among them, 95 patients received tocilizumab treatment on the basis of standard treatment
.
The propensity score analysis matched 95 patients who received only standard treatment .
The results showed that the fatality rate of the tocilizumab treatment group was lower than that of the standard treatment group, but the difference was not statistically significant
.
It was also found that in the ICU stratified analysis, the mortality rate of the tocilizumab treatment group was significantly lower than that of the standard treatment group
.
In the subgroup without secondary infection, the mortality rate of the tocilizumab treatment group was significantly lower than that of the standard treatment group
.
According to the inclusion criteria, the research team selected 49 relevant documents through literature search
.
A meta-analysis of 49 studies (6568 tocilizumab plus standard treatment patients and 11660 standard treatment patients) found that receiving tocilizumab significantly reduced patient mortality
.
We also found similar results in some subgroups
.
Sequential test analysis (TSA analysis) shows that this is a true positive result
.
No significant correlation was found between tocilizumab and increased risk of secondary infection, discharge rate, adverse events, and mechanical ventilation
.
This meta-analysis showed that tocilizumab significantly reduced the mortality rate of COVID-19 patients, but did not increase the risk of discharge, secondary infection, adverse events, and mechanical ventilation
.
The study suggests that clinicians should pay attention to tocilizumab treatment as a potentially effective and safe treatment for COVID-19 patients
.
Jiang Weijun, Jinling Hospital (Eastern Theater General Hospital) of Nanjing University School of Medicine is the first author of the paper, and Professor Xia Xinyi is the corresponding author
.
Link to the paper: https://link.
springer.
com/article/10.
1007/s40121-021-00483-x Open for reprint
.
However, the clinical efficacy and safety of tocilizumab in the treatment of patients with new coronary pneumonia have always been controversial
.
Epidemiological studies and recent retrospective studies have shown that circulating interleukin 6 (IL-6), IL-1Ra, IL-1b, IL-10, IL-17, IL- 18.
Interferon c (IFN-c), tumor necrosis factor a (TNF-a), c-reactive protein (CRP), granulocyte colony stimulating factor (G-CSF) and macrophage colony stimulating factor (M-CSF) , Suggesting the rapid activation of the innate immune response
.
Multiple studies have shown that increased plasma IL-6 levels in COVID-19 patients in the intensive care unit seem to be positively correlated with mortality
.
In an observational study, the anti-IL-6 receptor monoclonal antibody tocilizumab has been approved for the treatment of a variety of inflammatory diseases and appears to improve the prognosis of COVID-19 patients in several countries
.
Some recent studies have shown that tocilizumab may be closely related to the low risk of intubation or death in severe and critically ill patients with COVID-19 pneumonia
.
Since the clinical severity of COVID-19 patients seems to be related to the cytokine storm and the excessive production of soluble inflammatory mediators, the current research results on the efficacy of tocilizumab in the treatment of COVID-19 patients are inconsistent
.
On July 10, 2021, Professor Xia Xinyi’s team from Jinling Hospital Affiliated to Nanjing University School of Medicine (Eastern Theater General Hospital) published a titled “Efficacy and Safety of Tocilizumab Treatment COVID-19 Patients: A Case-” in the journal Infectious Diseases and Therapy.
Control Study and Meta-Analysis paper
.
In this study, 190 COVID-19 patients were analyzed.
Among them, 95 patients received tocilizumab treatment on the basis of standard treatment
.
The propensity score analysis matched 95 patients who received only standard treatment .
The results showed that the fatality rate of the tocilizumab treatment group was lower than that of the standard treatment group, but the difference was not statistically significant
.
It was also found that in the ICU stratified analysis, the mortality rate of the tocilizumab treatment group was significantly lower than that of the standard treatment group
.
In the subgroup without secondary infection, the mortality rate of the tocilizumab treatment group was significantly lower than that of the standard treatment group
.
According to the inclusion criteria, the research team selected 49 relevant documents through literature search
.
A meta-analysis of 49 studies (6568 tocilizumab plus standard treatment patients and 11660 standard treatment patients) found that receiving tocilizumab significantly reduced patient mortality
.
We also found similar results in some subgroups
.
Sequential test analysis (TSA analysis) shows that this is a true positive result
.
No significant correlation was found between tocilizumab and increased risk of secondary infection, discharge rate, adverse events, and mechanical ventilation
.
This meta-analysis showed that tocilizumab significantly reduced the mortality rate of COVID-19 patients, but did not increase the risk of discharge, secondary infection, adverse events, and mechanical ventilation
.
The study suggests that clinicians should pay attention to tocilizumab treatment as a potentially effective and safe treatment for COVID-19 patients
.
Jiang Weijun, Jinling Hospital (Eastern Theater General Hospital) of Nanjing University School of Medicine is the first author of the paper, and Professor Xia Xinyi is the corresponding author
.
Link to the paper: https://link.
springer.
com/article/10.
1007/s40121-021-00483-x Open for reprint
