ArticleCritical care explorations2026
Tocilizumab Efficacy Across Inflammatory Subphenotypes in COVID-19-Related Acute Respiratory Distress Syndrome.
Article in Critical care explorations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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10 authors.
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Abstract
objectivesThis study evaluated whether the established efficacy of tocilizumab, an interleukin-6 (IL-6) receptor antagonist, differs between the hypoinflammatory and hyperinflammatory subphenotypes.
designRetrospective analysis of data from three biobanks.
settingICUs of three university teaching hospitals in the Netherlands. PATIENTS: Mechanically ventilated patients with COVID-19.
interventionsTocilizumab administration vs. no administration. MEASUREMENTS AND MAIN
resultsA total of 561 patients were included. Based on a classifier model incorporating IL-6, tumor necrosis factor receptor 1, and bicarbonate, 95% were classified as Hypoinflammatory and 5% as Hyperinflammatory. Tocilizumab was associated with a significant reduction in 30-day mortality in the overall cohort, even after adjustment for confounders (p = 0.014). However, there was no evidence that treatment effectiveness differed between the two subphenotypes (p = 0.59).
conclusionsIn this cohort, tocilizumab significantly reduced 30-day mortality overall. Although the number of Hyperinflammatory patients was low, there was no evidence that its efficacy differed between inflammatory subphenotypes. These findings underscore the importance of including both subphenotypes in future trials evaluating the differential effects of tocilizumab.
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