Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review
- Authors: Cortegiani A.; Ippolito M.; Greco M.; Granone V.; Protti A.; Gregoretti C.; Giarratano A.; Einav S.; Cecconi M.
- Publication year: 2020
- Type: Articolo in rivista
- Key words: Coronavirus, COVID-19, Pneumonia, SARS-CoV-2, Tocilizumab
- OA Link: http://hdl.handle.net/10447/430755
Abstract
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.