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The effect of tocilizumab on mortality in hospitalized patients with COVID-19: a meta-analysis of randomized

Chia Siang Kow1, Syed Shahzad Hasan2,3

  • 1School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia. chiasiang_93@hotmail.com.

European Journal of Clinical Pharmacology
|February 3, 2021
PubMed

Insights

Tocilizumab did not significantly reduce mortality in COVID-19 patients. However, this drug may decrease the need for mechanical ventilation in critically ill patients with coronavirus disease 2019.

Area of Science:

  • Immunology
  • Critical Care Medicine
  • Pharmacology

Background:

  • Tocilizumab is an interleukin-6 receptor inhibitor investigated for treating severe COVID-19.
  • The drug's efficacy on mortality and disease progression remains a critical research question.

Purpose of the Study:

  • To conduct a meta-analysis of randomized controlled trials (RCTs).
  • To evaluate the overall effect of tocilizumab on mortality risk in COVID-19 patients.

Main Methods:

  • Systematic literature search of major databases and preprint repositories.
  • Meta-analysis using random-effects and inverse variance heterogeneity models.
  • Risk of bias assessment using the Cochrane risk-of-bias tool (version 2).

Main Results:

  • Six RCTs (n=2,057) were included, with varying risk of bias.
  • No significant reduction in all-cause mortality was observed with tocilizumab (HR 0.83; 95% CI 0.66-1.05).
  • Tocilizumab showed a trend towards reducing mechanical ventilation or mortality (HR 0.62; 95% CI 0.42-0.91).

Conclusions:

  • Tocilizumab does not demonstrate clear mortality benefits in hospitalized COVID-19 patients.
  • The drug may reduce the likelihood of requiring mechanical ventilation.
Abstract

Keywords:
BiasCOVID-19Clinical trialMortalityTocilizumab

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