SynthesisIntensive care medicine2021
Tocilizumab in COVID-19: a meta-analysis, trial sequential analysis, and meta-regression of randomized-controlled trials.
Synthesis in Intensive care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- The Cytokine Release Syndrome and/or the Proinflammatory Cytokines as Underlying Mechanisms of Downregulation of Drug Metabolism and Drug Transport: A Systematic Review of the Clinical Pharmacokinetics of Victim Drugs of this Drug-Disease Interaction Under Different Clinical Conditions.Clinical pharmacokinetics · 2022Pooled it
- Identifying factors contributing to increased susceptibility to COVID-19 risk: a systematic review of Mendelian randomization studies.International journal of epidemiology · 2022Pooled it
- 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
- A randomised controlled trial of plasma exchange compared to standard of care in the treatment of severe COVID-19 infection (COVIPLEX).Scientific reports · 2024Trial
- Trial
- Real-World Tocilizumab Use in Pediatric Inpatients.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Effectiveness and Safety of Oral Azvudine for Elderly Hospitalized Patients With COVID-19: A Multicenter, Retrospective, Real-World Study.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Review
- Cytokine, Anti-SARS-CoV-2 Antibody, and Neutralizing Antibody Levels in Conventional Blood Donors Who Have Recovered from COVID-19.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2024Article
- Therapeutic Impact of Tocilizumab in the Setting of Severe COVID-19; an Updated and Comprehensive Review on Current Evidence.Archives of academic emergency medicine · 2024Article
- Cytokine storm and translating IL-6 biology into effective treatments for COVID-19.Frontiers of medicine · 2023Review
- Does tocilizumab have an effect on the clinical outcomes in COVID-19 patients? A meta-analysis of randomized control trials.Journal of pharmaceutical policy and practice · 2023Article
- COVID-19 outcomes in patients with rheumatoid arthritis with biologic or targeted synthetic DMARDs.RMD open · 2023Article
- The Impact of Therapeutic Plasma Exchange on Inflammatory Markers and Acute Phase Reactants in Patients with Severe SARS-CoV-2 Infection.Medicina (Kaunas, Lithuania) · 2023Review
- Assessing the Outcomes of Patients with Severe SARS-CoV-2 Infection after Therapeutic Plasma Exchange by Number of TPE Sessions.Journal of clinical medicine · 2023Article
- Effects of Tocilizumab on Inflammation and Iron Metabolism in Critically Ill Patients with COVID-19.Pharmaceutics · 2023Article
- Review
- [Should we interfere with the interleukin-6 receptor during COVID-19: What do we know?]Revue des maladies respiratoires · 2023Review
- Should We Interfere with the Interleukin-6 Receptor During COVID-19: What Do We Know So Far?Drugs · 2023Review
- [Journal of personalized medicine · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeInterleukin-6 (IL-6) levels discriminate between patients with mild and severe COVID-19, making IL-6 inhibition an attractive therapeutic strategy. We conducted a systematic review, meta-analysis, trial sequential analysis (TSA), and meta-regression of randomized-controlled trials to ascertain the benefit of IL-6 blockade with tocilizumab for COVID-19.
methodsWe included randomized-controlled trials (RCTs) allocating patients with COVID-19 to tocilizumab. Our control group included standard care or placebo. Trials co-administering other pharmacological interventions for COVID-19 were not excluded. Primary outcome was 28-30 day mortality. Secondary outcomes included progression-to-severe disease defined as need for mechanical ventilation, intensive-care unit (ICU) admission, or a composite.
resultsWe identified 10 RCTs using tocilizumab, 9 of which reported primary outcome data (mortality), recruiting 6493 patients with 3358 (52.2%) allocated to tocilizumab. Tocilizumab may be associated with an improvement in mortality (24.4% vs. 29.0%; OR 0.87 [0.74-1.01]; p = 0.07; I
conclusionsFor hospitalized COVID-19 patients, there is some evidence that tocilizumab use may be associated with a short-term mortality benefit, but further high-quality data are required. Its benefits may also lie in reducing the need for mechanical ventilation.
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Registered trials
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.