Evidence map›Paper›PMID 34247325›Full record

ReviewInfectious diseases and therapy2021

Systematic Review and Subgroup Meta-analysis of Randomized Trials to Determine Tocilizumab's Place in COVID-19 Pneumonia.

Timothée Klopfenstein, Vincent Gendrin, Aurélie Gerazime, Thierry Conrozier, Jean-Charles Balblanc, Pierre-Yves Royer, Anne Lohse, Chaouki Mezher, Lynda Toko, Cerise Guillochon and 6 more

Open access · goldAbstract readReview
In one paragraph

Review in Infectious diseases and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 3 pooled it
1.1field-weighted citation impact, top 19% 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

13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Early administration of tocilizumab in hospitalized COVID-19 patients with elevated inflammatory markers; COVIDSTORM-a prospective, randomized, single-centre, open-label study.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2022
    Trial
  5. Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Medicina (Kaunas, Lithuania) · 2022
    Review
  11. Article
  12. Observational
  13. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 2 institutions in 1 country.

Timothée KlopfensteinInfectious Disease Department, Nord Franche-Comté Hospital, 90400, Trevenans, France. timothee.klopfenstein@hnfc.fr.ORCID http://orcid.org/0000-0003-4334-9889
Vincent GendrinInfectious Disease Department, Nord Franche-Comté Hospital, 90400, Trevenans, France.
Aurélie GerazimeMethodology Unit, Clinical Investigation Center INSERM 1431, Jean-Minjoz University Hospital, Besançon, France.
Thierry ConrozierRheumatology Department, Nord Franche-Comté Hospital, Trevenans, France.
Jean-Charles BalblancRheumatology Department, Nord Franche-Comté Hospital, Trevenans, France.
Pierre-Yves RoyerInfectious Disease Department, Nord Franche-Comté Hospital, 90400, Trevenans, France.
Anne LohseRheumatology Department, Nord Franche-Comté Hospital, Trevenans, France.
Chaouki MezherIntensive Care Unit Department, Nord Franche-Comté Hospital, Trevenans, France.
Lynda TokoInfectious Disease Department, Nord Franche-Comté Hospital, 90400, Trevenans, France.
Cerise GuillochonRheumatology Department, Nord Franche-Comté Hospital, Trevenans, France.
Julio BadieIntensive Care Unit Department, Nord Franche-Comté Hospital, Trevenans, France.
Alix PierronInfectious Disease Department, Nord Franche-Comté Hospital, 90400, Trevenans, France.
N 'dri Juliette Kadiane-OussouInfectious Disease Department, Nord Franche-Comté Hospital, 90400, Trevenans, France.
Marc PuyraveauMethodology Unit, Clinical Investigation Center INSERM 1431, Jean-Minjoz University Hospital, Besançon, France.
Souheil ZayetInfectious Disease Department, Nord Franche-Comté Hospital, 90400, Trevenans, France. souhail.zayet@gmail.com.
HNF Hospital tocilizumab multidisciplinary team
L'Hôpital Nord Franche-Comté · FRInserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTocilizumab randomized clinical trial results are heterogeneous because of the heterogenous population included in them.

methodsWe conducted a meta-analysis with subgroup meta-analysis (PRISMA guidelines) between severe and non-severe COVID-19.

resultsWe included nine trials. Overall, the mortality rate was 24.5% (821/3357) in the tocilizumab group and 29.1% (908/3125) in the control group at day 28-30 (pooled OR, 0.85; 95% CI 0.76-0.96; p = 0.006). Considering the subgroup analysis, this benefit on mortality was confirmed and amplified in the severe COVID-19 group (pooled OR, 0.82; 95% CI 0.73-0.93; p = 0.001) but not in the non-severe COVID-19 group (pooled OR, 1.46; 95% CI 0.91-2.34; p = 0.12). For patients who were not mechanically ventilated at baseline (5523/6482), the pooled OR (0.74; 95% CI 0.64-0.85; p < 0.0001) for mechanical ventilation incidence at day 28-30 was in favor of tocilizumab (cumulative incidence of 14.8% versus 19.4% in tocilizumab and control arm, respectively). This benefit was confirmed in both subgroups, i.e., severe and non-severe COVID-19.

conclusionTocilizumab is an effective treatment in hospitalized patients with COVID-19 and hypoxemia by improving survival and decreasing mechanical ventilation requirement. The greatest benefit is observed in severe COVID-19.

Indexed as

Coronavirus disease 2019Meta-analysisRandomized clinical trialReviewTocilizumab

Identifiers

PMID34247325
PMCPMC8272840
OpenAlexW3178608608

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.