Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review

• Published in: Pulmonology
• Main Authors: A. Cortegiani, M. Ippolito, M. Greco, V. Granone, A. Protti, C. Gregoretti, A. Giarratano, S. Einav, M. Cecconi
• Format: Article
• Language: English
• Published: Taylor & Francis Group 2021-01-01
• Subjects: COVID-19; Tocilizumab; SARS-CoV-2; Pneumonia; Coronavirus
• Online Access: https://www.tandfonline.com/doi/10.1016/j.pulmoe.2020.07.003

Background Tocilizumab is an IL-6 receptor-blocking agent proposed for the treatment of severe COVID-19. The aim of this systematic review was to describe the rationale for the use of tocilizumab for the treatment of COVID-19 and to summarize the available evidence regarding its efficacy and safety.Methods MEDLINE, PubMed, EMBASE, pre-print repositories (bioRxiv and medRxiv) and two trial Registries were searched for studies on the use of tocilizumab in COVID-19 or SARS-CoV-2 infection, viral pneumonia, and/or sepsis until 20th June 2020.Results We identified 3 indirect pre-clinical studies and 28 clinical studies including 5776 patients with COVID-19 (13 with a comparison group, 15 single-arm). To date, no randomized trials have been published. We retrieved no studies at low risk of bias. Forty-five ongoing studies were retrieved from trial registries.Conclusions There is insufficient evidence regarding the clinical efficacy and safety of tocilizumab in patients with COVID-19. Its use should be considered experimental, requiring ethical approval and clinical trial oversight.