COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

Treatment Cortegiani A, Ippolito M, Greco M, et al. Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review. Pulmonology. 2020 Jul 20. pii: S2531-0437(20)30153-7. doi: 10.1016/j.pulmoe.2020.07.003.
Abstract

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.

Ratings
Discipline / Specialty Area Score
Infectious Disease
Respirology/Pulmonology
Intensivist/Critical Care
Hospital Doctor/Hospitalists
Internal Medicine
Comments from MORE raters

Infectious Disease rater

It is better to use it in those patients.

Respirology/Pulmonology rater

This is a very useful article.

Respirology/Pulmonology rater

This is a highly informative paper of the available evidence regarding its efficacy and safety of tocilizumab for the treatment of COVID-19. This study highlights that there is a pressing need for knowledge regarding COVID-19 care pathway, that currently, applies to pre-print or peer-reviewed studies that have moderate or serious risk of bias.