Evidence map›Paper›PMID 33745918›Full record

SynthesisThe Journal of infection2021

IL-6 inhibition in the treatment of COVID-19: A meta-analysis and meta-regression.

Emmanuel Tharmarajah, April Buazon, Vishit Patel, Jennifer R Hannah, Maryam Adas, Victoria B Allen, Katie Bechman, Benjamin D Clarke, Deepak Nagra, Sam Norton and 4 more

Open access · bronzeAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Journal of infection, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 6 pooled it
3.4field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 6 syntheses or guidelines pooled it, 58 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Review
  13. The CD38Frontiers in immunology · 2025
    Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Observational
  19. Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 1 institution in 1 country.

Emmanuel TharmarajahCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
April BuazonCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
Vishit PatelCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
Jennifer R HannahCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
Maryam AdasCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
Victoria B AllenCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
Katie BechmanCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
Benjamin D ClarkeCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
Deepak NagraCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
Sam NortonCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
Mark D RussellCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK. Electronic address: mark.russell@kcl.ac.uk.
Andrew I RutherfordCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
Mark YatesCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
James B GallowayCentre for Rheumatic Diseases, Weston Education Centre, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK.
King's College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesMultiple RCTs of interleukin-6 (IL-6) inhibitors in COVID-19 have been published, with conflicting conclusions. We performed a meta-analysis to assess the impact of IL-6 inhibition on mortality from COVID-19, utilising meta-regression to explore differences in study results.

methodsSystematic database searches were performed to identify RCTs comparing IL-6 inhibitors (tocilizumab and sarilumab) to placebo or standard of care in adults with COVID-19. Meta-analysis was used to estimate the relative risk of mortality at 28 days between arms, expressed as a risk ratio. Within-study mortality rates were compared, and meta-regression was used to investigate treatment effect modification.

resultsData from nine RCTs were included. The combined mortality rate across studies was 19% (95% CI: 18, 20%), ranging from 2% to 31%. The overall risk ratio for 28-day mortality was 0.90 (95% CI: 0.81, 0.99), in favour of benefit for IL-6 inhibition over placebo or standard of care, with low treatment effect heterogeneity: I

conclusionsIL-6 inhibition is associated with clinically meaningful improvements in outcomes for patients admitted with COVID-19. Long-term benefits of IL-6 inhibition, its effectiveness across healthcare systems, and implications for differing standards of care are currently unknown.

Indexed as

COVID-19Interleukin-6AdultHumansMaleOdds RatioSARS-CoV-2Interleukin-6COVID-19IL-6Meta-analysisSarilumabTocilizumab

Identifiers

PMID33745918
PMCPMC7970418
OpenAlexW3137252557

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.