Abstract
Tocilizumab is an interleukin receptor inhibitor that has been used in patients with COVID-19 pneumonia. There are recent randomized controlled trials (RCTs) that evaluated the efficacy and safety of tocilizumab in hospitalized patients with COVID-19 pneumonia. We performed a systematic review and meta-analysis of RCTs that evaluated the effectiveness of tocilizumab in hospitalized patients with COVID-19 not requiring mechanical ventilation. RCTs comparing tocilizumab with the standard of care treatment in hospitalized patients with COVID-19 pneumonia not requiring mechanical ventilation at the time of administration were included for analysis. The primary outcome was a composite of mechanical ventilation or 28-day mortality and the secondary outcomes were 28-day mortality and major adverse events. A total of 6 RCTs were included for the analysis. Tocilizumab was associated with a statistically significant reduction in the primary composite outcome of mechanical ventilation or 28-day mortality (risk ratio (RR): 0.83 (95% CI: 0.74 to 0.92, I 2 =0, tau 2 =0). Treatment with tocilizumab did not show a statistically significant reduction in 28-day mortality (RR: 0.90 (95% CI: 0.76 to 1.07), I 2 =0, tau 2 =0) and rate of serious adverse events (RR: 0.82 (95% CI: 0.62 to 1.10), I 2 =0, tau 2 =0). Tocilizumab was associated with a decrease in the incidence of primary outcome, that is, mechanical ventilation or death at 28 days in hospitalized patients with COVID-19 pneumonia.
Keywords: COVID-19; adult; anti-inflammatory agents; non-steroidal; pneumonia; respiratory distress syndrome.
【저자키워드】 COVID-19, Adult, Pneumonia, anti-inflammatory agents, non-steroidal, respiratory distress syndrome., 【초록키워드】 Randomized controlled trial, Treatment, Meta-analysis, Respiratory distress syndrome, COVID-19 pneumonia, Anti-inflammatory, mechanical ventilation, Tocilizumab, 28-day mortality, systematic review, risk, outcome, hospitalized patients, RCT, adverse events, Effectiveness, death, Efficacy and safety, receptor, incidence, inhibitor, anti-inflammatory agents, RCTs, administration, Analysis, distress, risk ratio, Composite, respiratory distress, Standard of care, Serious Adverse Events, Serious Adverse Event, Primary outcome, Secondary outcomes, syndrome, secondary outcome, decrease, statistically significant reduction, performed, evaluated, hospitalized patient, patients with COVID-19, with COVID-19, 【제목키워드】 Randomized controlled trial, Meta-analysis, patients hospitalized, with COVID-19,