https://doi.org/10.4081/monaldi.2022.2136
Tocilizumab for COVID-19: A systematic review and meta-analysis of randomized controlled trials
Submitted: October 24, 2021
Accepted: January 17, 2022
Published: February 4, 2022
Accepted: January 17, 2022
Abstract Views: 2311
PDF: 1041
Supplementary: 210
Supplementary: 210
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The effective treatment modalities for severe coronavirus disease 2019 (COVID-19) are needed. As the primary cause of mortality is a hyperinflammatory state, the interleukin-6 antagonist tocilizumab has been used in multiple clinical studies. We conducted this systematic review and meta-analysis to estimate the effectiveness of tocilizumab in reduction of mortality due to COVID-19. A systematic search of the Pubmed and Embase databases was performed to extract randomized controlled trials (RCTs) regarding the use of tocilizumab therapy for COVID-19. An overall pooled mortality analysis was performed, and odds ratios were reported. Cochrane risk of bias assessment tool was used to assess the risk of bias. Heterogeneity was assessed using the I2 statistic. Nine RCTs, including 6489 patients, were selected for meta-analysis. Seven trials reported 28-day mortality, and one trial each reported 21-day and 30-day mortality. There were 846 deaths among 3358 participants in the steroid group while 943 deaths among 3131 patients randomized to the control group (random-effects odds ratio 0.87, 95% confidence interval 0.73-1.03, p=0.11). There was some heterogeneity among the trials as the I2 value was 15%, with a p-value of 0.31. There was a reduction in the need for ICU admission in the tocilizumab group. A higher risk of secondary infections was noted in the tocilizumab group (fixed-effects odds ratio 0.72, 95% confidence interval 0.55-0.95, p=0.02). This meta-analysis of RCTs demonstrated that the use of tocilizumab was not associated with a reduction in all-cause mortality in patients with COVID-19 and had higher odds of secondary infections.
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How to Cite
Boppana, Tarun Krishna, Saurabh Mittal, Karan Madan, Anant Mohan, Vijay Hadda, and Randeep Guleria. 2022. “Tocilizumab for COVID-19: A Systematic Review and Meta-Analysis of Randomized Controlled Trials”. Monaldi Archives for Chest Disease 92 (4). https://doi.org/10.4081/monaldi.2022.2136.
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