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Open Access 01-12-2021 | Tocilizumab | Research

Efficacy and safety of IL-6 inhibitors in patients with COVID-19 pneumonia: a systematic review and meta-analysis of multicentre, randomized trials

Authors: Alessandro Belletti, Corrado Campochiaro, Marilena Marmiere, Valery Likhvantsev, Andrey Yavorovskiy, Lorenzo Dagna, Giovanni Landoni, Alberto Zangrillo, Ludhmila Abrahão Hajjar

Published in: Annals of Intensive Care | Issue 1/2021

Abstract

Purpose

COVID-19 is characterized by dysregulated immune response, respiratory failure and a relevant mortality rate among hospitalized patients. Interleukin-6 (IL-6) is involved in COVID-19-associated cytokine storm, and several trials investigated whether its inhibition could improve patients’ outcome. We performed a meta-analysis of randomized trials (RCT) to test this hypothesis.

Materials and methods

Two independent investigators searched PubMed, Scopus, ClnicalTrials.gov and medRxiv up to September 1st, 2021. Inclusion criteria were: administration of tocilizumab or sarilumab; COVID-19 adult patients with pneumonia; and being a RCT. Primary outcome was mortality at the longest follow-up. Secondary outcomes included intubation rate and incidence of adverse events. Two independent investigators extracted data from eligible trials.

Results

Of the 763 studies assessed, 15 RCTs were included (9,320 patients), all were multicentre, and the majority open-label vs standard treatment. IL-6 inhibitors were associated with reduced all-cause mortality at the longest follow-up (1315/5,380 [24.4%] in the IL-6 inhibitors group versus 1080/3,814 [28.3%] in the control group, RR = 0.90; 95% CI 0.84 to 0.96; p for effect = 0.003, I² = 0%, with 13 studies included), with reduction in 28/30-day mortality and intubation rates, and with no increase in adverse events and secondary infections.

Conclusion

IL-6 inhibitors reduced longest follow-up mortality and intubation in COVID-19 patients. Findings need to be confirmed in high-quality RCTs.

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Title: Efficacy and safety of IL-6 inhibitors in patients with COVID-19 pneumonia: a systematic review and meta-analysis of multicentre, randomized trials
Authors: Alessandro Belletti
Corrado Campochiaro
Marilena Marmiere
Valery Likhvantsev
Andrey Yavorovskiy
Lorenzo Dagna
Giovanni Landoni
Alberto Zangrillo
Ludhmila Abrahão Hajjar
Publication date: 01-12-2021
Publisher: Springer International Publishing
Keywords: Tocilizumab
Sarilumab
Pneumonia
COVID-19
Published in: Annals of Intensive Care / Issue 1/2021
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/s13613-021-00941-2

2024 ASCO Annual Meeting

Springer Medicine

Efficacy and safety of IL-6 inhibitors in patients with COVID-19 pneumonia: a systematic review and meta-analysis of multicentre, randomized trials

Abstract

Purpose

Materials and methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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