Observational studyEuropean journal of hospital pharmacy : science and practice2022
Does timing matter on tocilizumab administration? Clinical, analytical and radiological outcomes in COVID-19.
Observational study in European journal of hospital pharmacy : science and practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Decreased mortality and increased side effects in COVID-19 patients treated with IL-6 receptor antagonists: systematic review and meta-analysis.Scientific reports · 2021Pooled it
- Effects of COVID-19 on the Liver and Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta and Non-Delta Variants: An Analysis in a Single Centre.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Clinical Disease Characteristics and Treatment Trajectories Associated with Mortality among COVID-19 Patients in Punjab, Pakistan.Healthcare (Basel, Switzerland) · 2023Article
- Tocilizumab in COVID-19 management: addressing time of starting treatment.European journal of hospital pharmacy : science and practice · 2023Article
- Efficacy and safety of Tocilizumab, plasmapheresis and their combination in severe COVID-19: A randomized clinical trial.International immunopharmacology · 2023Review
- Article
- Analysis of the factors predicting clinical response to tocilizumab therapy in patients with severe COVID-19.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Article
- Treatment with Tocilizumab in Adult Patients with Moderate to Critical COVID-19 Pneumonia: A Single-Center Retrospective Study.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Article
- The Impact of Tocilizumab on Radiological Changes Assessed by Quantitative Chest CT in Severe COVID-19 Patients.Journal of clinical medicine · 2022Article
- Barotrauma, invasive ventilation, and timing of tocilizumab as predictors of mortality along with inflammatory markers and comorbidities in critically ill COVID-19 patients: A retrospective study.Indian journal of anaesthesia · 2021Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWhile there are no pharmacological treatments with proven efficacy for coronavirus disease 2019 (COVID-19), tocilizumab has emerged as a candidate therapy. Some aspects of this therapy are still unknown, including the optimal timing of administration.
objectiveThis observational study aimed to compare the 90-day mortality in two cohorts of patients when the drug was administered within the first 10 days from onset of symptoms or after day 11.
methodsPatients hospitalised with severe COVID-19 pneumonia who had received tocilizumab were divided into two groups according to when the medication was administered. The primary outcome was 90-day mortality. Secondary outcomes were 30-day mortality, clinical improvement on a 6-item scale by day 6, biomarker improvement by day 6, radiological image improvement by day 10 and SaO
resultsA total of 112 patients were analysed. Both groups were epidemiologically comparable. The results obtained in the primary efficacy variable of the study (90-day mortality) showed a statistically significant difference in the subgroups according to the time of administration of tocilizumab (18.6% vs 5.0%, p=0.048). There was clinical improvement in 24.1% of patients at 6 days, with similar behaviour in both subgroups. No statistically significant differences were found in the percentage of patients who achieved radiological improvement at 10 days or in the other inflammatory parameters, with the exception of significant reductions in lactate dehydrogenase and C-reactive protein. Administration of tocilizumab was not associated with relevant adverse events.
conclusionTo our knowledge, this is the first report of data regarding the timing of administration of tocilizumab in patients with COVID-19 pneumonia. A strategy involving tocilizumab administration after 10 days from onset of symptoms may decrease mortality. Further randomised controlled trials are needed to confirm this emerging hypothesis.
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