Evidence map›Paper›PMID 34605114›Full record

SynthesisRespirology (Carlton, Vic.)2021

Tocilizumab administration for the treatment of hospitalized patients with COVID-19: A systematic review and meta-analysis.

Christos Kyriakopoulos, Georgios Ntritsos, Athena Gogali, Haralampos Milionis, Evangelos Evangelou, Konstantinos Kostikas

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

Synthesis in Respirology (Carlton, Vic.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
2.3field-weighted citation impact, top 9% 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

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.

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  15. Proteomic analysis and identification reveal the anti-inflammatory mechanism of clofazimine on lipopolysaccharide-induced acute lung injury in mice.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2022
    Article
  16. The safety and effectiveness of tocilizumab in older adult critically ill patients with COVID-19: a multicenter, cohort study.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Christos KyriakopoulosRespiratory Medicine Department, University of Ioannina Faculty of Medicine, Ioannina, Greece.ORCID 0000-0001-8806-2561
Georgios NtritsosDepartment of Hygiene and Epidemiology, University of Ioannina Faculty of Medicine, Ioannina, Greece.
Athena GogaliRespiratory Medicine Department, University of Ioannina Faculty of Medicine, Ioannina, Greece.
Haralampos MilionisInternal Medicine Department, University of Ioannina Faculty of Medicine, Ioannina, Greece.
Evangelos EvangelouDepartment of Hygiene and Epidemiology, University of Ioannina Faculty of Medicine, Ioannina, Greece.
Konstantinos KostikasRespiratory Medicine Department, University of Ioannina Faculty of Medicine, Ioannina, Greece.ORCID 0000-0003-0774-3942
University of Ioannina · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Tocilizumab has been repurposed against the 'cytokine storm' in the setting of coronavirus disease 2019 (COVID-19). Our aim was to evaluate the efficacy of tocilizumab in the management of hospitalized COVID-19 patients. We searched MEDLINE, CENTRAL and medRxiv for studies of tocilizumab in hospitalized COVID-19 patients. Primary objective was the effectiveness of tocilizumab on mortality. Secondary objectives included the need for invasive mechanical ventilation (IMV), composite endpoints of mortality or IMV and intensive care unit (ICU) admission or IMV, length of hospitalization and differences in mortality in subgroups (ICU and non-ICU patients and patients receiving or not receiving concomitant corticosteroids). We included 52 studies (nine randomized controlled trials [RCTs] and 43 observational) with a total of 27,004 patients. In both RCTs and observational studies, the use of tocilizumab was associated with a reduction in mortality; 11% in RCTs (risk ratio [RR] 0.89, 95% CI 0.82 to 0.96) and 31% in observational studies (RR 0.69, 95% CI 0.58 to 0.83). The need for IMV was reduced by 19% in RCTs (RR 0.81, 95% CI 0.71 to 0.93), while no significant reduction was observed in observational studies. Both RCTs and observational studies showed a benefit from tocilizumab on the composite endpoint of mortality or IMV. Tocilizumab improved mortality both in ICU and non-ICU patients. Reduction in mortality was evident in observational studies regardless of the use of systemic corticosteroids, while that was not the case in the RCTs. Tocilizumab was associated with lower mortality and other clinically relevant outcomes in hospitalized patients with moderate-to-critical COVID-19.

Indexed as

COVID-19 Drug TreatmentAntibodies, Monoclonal, HumanizedCOVID-19Hospital MortalityHumansRespiration, ArtificialSARS-CoV-2Antibodies, Monoclonal, Humanizedtocilizumabcoronavirus diseaseCOVID-19meta-analysismortalitySARS-CoV-2tocilizumab

Identifiers

PMID34605114
PMCPMC8661720
OpenAlexW3202642696

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.