SynthesisClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2023
Effect of tocilizumab, sarilumab, and baricitinib on mortality among patients hospitalized for COVID-19 treated with corticosteroids: a systematic review and meta-analysis.
Synthesis in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 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
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Effectiveness of pharmacological treatments for COVID-19 due to SARS-CoV-2: a systematic literature review.Frontiers in pharmacology · 2025Pooled it
- Effect of tocilizumab, sarilumab, and baricitinib on mortality among patients hospitalized for COVID-19 treated with corticosteroids: a systematic review and meta-analysis.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2023Pooled it
- Effects of Siltuximab Versus Corticosteroids in Preventing COVID-19 Pneumonia Disease Progression: Multicentre, Open-Label, Randomized Clinical Trial.Clinical and translational science · 2026Trial
- Multi-omics and artificial intelligence for precision drug discovery and potential clinical applications.Signal transduction and targeted therapy · 2026Review
- IL-6 Receptor Antagonists and Severe Post-COVID-19 Outcomes: An Emulated Target Trial.medRxiv : the preprint server for health sciences · 2026Article
- Clinical characteristics and risk factors associated with 28-day mortality among maintenance hemodialysis patients infected with Omicron variant of SARS-CoV-2.BMC infectious diseases · 2025Article
- Observational
- Real-World Tocilizumab Use in Pediatric Inpatients.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Dual efficacy of tocilizumab in managing PD-1 inhibitors-induced myocardial inflammatory injury and suppressing tumor growth with PD-1 inhibitors: a preclinical study.Cancer immunology, immunotherapy : CII · 2025Article
- Clinical characteristics and prognosis of COVID-19- associated invasive pulmonary aspergillosis in critically patients: a single-center study.Frontiers in cellular and infection microbiology · 2025Article
- Tocilizumab and IVIG experience during the service follow-up in patients with severe COVID-19 pneumonia.Revista do Instituto de Medicina Tropical de Sao Paulo · 2025Article
- Interleukin-6 drives endothelial glycocalyx damage in COVID-19 and bacterial sepsis.Angiogenesis · 2024Observational
- Harnessing immunity: Immunomodulatory therapies in COVID-19.World journal of virology · 2024Review
- Is perioperative COVID-19 really associated with worse surgical outcomes among vaccinated patients?Updates in surgery · 2024Article
- Clinical Outcomes among Hospitalized COVID-19 Patients Who Received Baricitinib or Tocilizumab in Addition to Standard of Care.Diseases (Basel, Switzerland) · 2024Article
- Tocilizumab (anti-IL-6) treatment for AA renal amyloidosis in a patient with advanced chronic kidney disease, a case report.Journal of nephrology · 2024Article
- Identification of FasL as a crucial host factor driving COVID-19 pathology and lethality.Cell death and differentiation · 2024Article
- Effect of Anti-Interleukin-6 Agents on Psychopathology in a Sample of Patients with Post-COVID-19 Syndrome: An Observational Study.Brain sciences · 2024Article
- Baricitinib versus tocilizumab in critically ill COVID-19 patients: A retrospective cohort study.Pharmacotherapy · 2024Observational
- Evaluation of IFNAR2 and TYK2 transcripts' prognostic role in COVID-19 patients: a retrospective study.Frontiers in cellular and infection microbiology · 2024Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRandomized controlled trials (RCT) established the mortality reduction by tocilizumab (Actemra), baricitinib (Olumiant), and sarilumab (Kevzara) in hospitalized COVID-19 patients. However, uncertainty remains about which treatment performs best in patients receiving corticosteroids.
objectivesTo estimate probabilities of noninferiority between baricitinib and sarilumab compared to tocilizumab in patients treated with corticosteroids. DATA SOURCES: PubMed, Embase, Cochrane Library, and MedRxiv. STUDY ELIGIBILITY CRITERIA: Eligible RCTs assigning hospitalized adults with COVID-19 treated with corticosteroids to tocilizumab or baricitinib or sarilumab versus standard of care or placebo (control).
methodsReviewers independently abstracted published data and assessed study quality with the Risk of Bias 2 tool. Unpublished data, if required, were requested from authors of included studies. The outcome of interest was all-cause mortality at 28 days.
participantsTwenty-seven RCTs with 13 549 patients were included. Overall, the risk of bias was low. Bayesian pairwise meta-analyses were used to aggregate results of each treatment versus control. The average odds ratio for mortality was 0.78 (95% credible interval [CrI]: 0.65, 0.94) for tocilizumab; 0.78 (95% CrI: 0.56, 1.03) for baricitinib; and 0.91 (95% CrI: 0.60, 1.40) for sarilumab. The certainty of evidence (GRADE) ranged from moderate to low. Bayesian meta-regressions with multiple priors were used to estimate probabilities of noninferiority (margin of 13% greater effect by tocilizumab). Compared to tocilizumab, there were ≤94% and 90% probabilities of noninferiority with baricitinib and sarilumab, respectively.
resultsAll but two studies included data with only indirect evidence for the comparison of interest.
conclusionsAmong hospitalized COVID-19 treated with corticosteroids, there are high probabilities that both baricitinib and sarilumab are associated with similar mortality reductions in comparison to tocilizumab.
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What OpenQuestion holds
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.