ArticleEuropean journal of internal medicine2020
Off-label use of tocilizumab for the treatment of SARS-CoV-2 pneumonia in Milan, Italy.
Article in European journal of internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 117 papers, 12 of them syntheses that pooled it.
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Who cites it
117 citing papers in PubMed, 12 syntheses or guidelines pooled it, 207 citations in OpenAlex.
- Interleukin-6 inhibitors reduce mortality in coronavirus disease-2019: An individual patient data meta-analysis from randomized controlled trials.European journal of internal medicine · 2022Pooled it
- Beneficial and harmful outcomes of tocilizumab in severe COVID-19: A systematic review and meta-analysis.Pharmacotherapy · 2021Pooled it
- Diabetes is most important cause for mortality in COVID-19 hospitalized patients: Systematic review and meta-analysis.Reviews in endocrine & metabolic disorders · 2021Pooled it
- Efficacy and safety of Tocilizumab in severe and critical COVID-19: A Systematic Review and Meta-Analysis.Expert review of clinical immunology · 2021Pooled it
- American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 2.Arthritis & rheumatology (Hoboken, N.J.) · 2021Guideline
- Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2021Pooled it
- A systematic review on treatment-related mucocutaneous reactions in COVID-19 patients.Dermatologic therapy · 2021Pooled it
- [Anti-IL-6 receptor antibody treatment for severe COVID-19 and the potential implication of IL-6 gene polymorphisms in novel coronavirus pneumonia].Medicina clinica · 2020Pooled it
- American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 1.Arthritis & rheumatology (Hoboken, N.J.) · 2020Guideline
- Tocilizumab for severe COVID-19: a systematic review and meta-analysis.International journal of antimicrobial agents · 2020Pooled it
- Addition of Tocilizumab to the Standard of Care Reduces Mortality in Severe COVID-19: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2020Pooled it
- Pooled it
- Efficacy and Safety of Sarilumab in Hospitalized Patients With Coronavirus Disease 2019: A Randomized Clinical Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- Subcutaneous tocilizumab in adults with severe and critical COVID-19: A prospective open-label uncontrolled multicenter trial.International immunopharmacology · 2020Trial
- Mechanisms and clinical research progress of IL-6-mediated crosstalk between the alveolar microenvironment and the immune system in patients with severe pneumonia undergoing mechanical ventilation.Frontiers in immunology · 2026Review
- A new flexible regression model with application to recovery probability Covid-19 patients.Journal of applied statistics · 2024Article
- Angiotensin-Converting Enzyme-2 (International journal of microbiology · 2023Article
- Identifying potential pharmacological targets and molecular pathways of Meliae cortex for COVID-19 therapy.Frontiers in immunology · 2023Article
- Therapeutic Efficacy and Outcomes of Remdesivir versus Remdesivir with Tocilizumab in Severe SARS-CoV-2 Infection.International journal of molecular sciences · 2022Article
- Retrospective Analysis of Clinical Laboratory Parameters, Therapeutics and Outcome in Patients Infected with SARS-CoV2.Indian journal of clinical biochemistry : IJCB · 2022Article
57 more citing papers are in PubMed but not listed here.
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Authors and funding
28 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTocilizumab, a humanized monoclonal antibody, targets IL-6 receptors blocking downstream pro-inflammatory effects of IL-6. In preliminary reports it was suggested to be beneficial in patients with severe COVID-19.
methodsIn this open-label prospective study we describe clinical characteristics and outcome of 51 patients hospitalized with confirmed and severe COVID-19 pneumonia treated with tocilizumab intravenously. All patients had elevated IL-6 plasma level (>40 pg/mL) and oxygen saturation <93% in ambient air. Clinical outcomes, oxygen support, laboratory data and adverse events were collected over a follow-up of 30 days.
resultsForty-five patients (88%) were on high-flow oxygen supplementation, six of whom with invasive ventilation. From baseline to day 7 after tocilizumab we observed a dramatic drop of body temperature and CRP value with a significant increase in lymphocyte count (p<0.001). Over a median follow-up time of 34 days from tocilizumab, 34 patients (67%) showed an improvement in their clinical severity class; 31 were discharged; 17 (33%) showed a worsening of their clinical status, of these 14 died (27%). The mortality rate was significantly associated with mechanical ventilation at baseline (83.3% vs 20% of patients on non-invasive oxygen support; p=0.0001). The most frequent side effects were an increase of hepatic enzymes (29%), thrombocytopenia (14%), and serious bacterial and fungal infections (27%).
conclusionTocilizumab exerts a rapidly beneficial effect on fever and inflammatory markers, although no significant impact on the clinical outcome can be inferred by our results. Critically ill patients seem to have a high risk of serious infections with this drug.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.