Current best evidence for clinical care (more info)
The pandemic caused by the new SARS-CoV2 coronavirus has led to an effort to find treatments that are effective against this disease that the World Health Organization calls COVID-19. In severe cases of COVID-19, there is an increase in cytokines, among which IL-6 seems to play an important role. A search has been performed for studies using IL-6 blocking drugs (tocilizumab, siltuximab, and sarilumab) in PubMed, Web of Science, and Scopus. Also, a search of ongoing trials registered at clinicaltrials.gov was performed. We found very little published clinical experience with these drugs, consisting mainly of case reports or case series with few patients. The results of clinical trials are necessary to clarify the role of these drugs in patients with COVID-19.
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The manuscript gives an overview of clinical studies - currently running or planned - addressing the efficacy of IL6-modulatory trials in COVID-19. However, this article will not have an impact on clinical practice since data already available do not allow a treatment recommendation, yet.
The prerequisite of using IL-6 antagonists in COVID-19 infection is recognizing IL-6 elevation in patients. Most clinical sites do not have this resource. It is unpractical for the most clinicians.