Does treatment with tocilizumab in patients with severe COVID-19 pneumonia lead to better outcomes than treatment with standard of care alone?

Bottom Line:

Treatment with tocilizumab can potentially reduce the risk of mechanical ventilation and death in patients with severe COVID-19 pneumonia.

Reference:

Guaraldi, G. et al. Tocilizumab in patients with severe COVID-19: a retrospective cohort study. The Lancet Rheumatology (2020). https://doi.org/10.1016/S2665-9913(20)30173-9

Date Published:

24 June 2020

Synopsis:

In severe cases, COVID-19 can cause pneumonia that may lead to mechanical ventilation or death. The most critical patients can develop a “cytokine storm”, a hyperactive state of the immune system that can cause long-term damage to the lungs. Tocilizumab is a type of drug that can block the activity of cytokines, and is approved for use in other immune-related conditions such as rheumatoid arthritis. This study was done to determine if treatment of COVID-19 pneumonia with tocilizumab leads to a lower risk of mechanical ventilation or death. The study included 544 adults with severe COVID-19 pneumonia admitted to hospitals in Italy. All patients were treated with standard of care (which includes supplemental oxygen along with a few other medications), with a subset of patients also receiving tocilizumab. The results showed that tocilizumab treatment, in addition to standard of care, was associated with a reduced risk of mechanical ventilation and death, compared to treatment with standard of care alone. However, since tocilizumab affects the immune system, it also led to a higher rate of infection among those patients who received it.

Summary by: Caroline Gregory