Abstract
Background: Studies have shown conflicting results on the efficacy of tocilizumab (TCZ) for patients with COVID-19, with many confounders of clinical status and limited duration of the observation. Here, we evaluate the real-world long-term efficacy of TCZ in COVID-19 patients.
Methods: We conducted a retrospective study of hospitalized adult patients with COVID-19 using a large US-based multicenter COVID-19 database (Cerner Real-World Data; updated in September, 2020). The TCZ group was defined as patients who received at least one dose of the drug. Matching weight (MW) and a propensity score weighting method were used to balance confounding factors.
Results: A total of 20,399 patients were identified. 1,510 and 18,899 were in the TCZ and control groups, respectively. After MW adjustment, no statistically significant differences in all-cause mortality were found for the TCZ vs. control group (Hazard Ratio [HR]:0.76, p=0.06). Survival curves suggested a better trend in short-term observation, driven from a subgroup of patients requiring oxygen masks, BIPAP or CPAP.
Conclusion: We observed a temporal (early) benefit of TCZ, especially in patients on non-invasive high-flow supplemental oxygen. However, the benefit effects faded with longer observation. The long-term benefits and risks of TCZ should be carefully evaluated with follow-up studies.
Keywords: COVID-19; De-identified Database; Tocilizumab.
【저자키워드】 COVID-19, Tocilizumab, De-identified Database, 【초록키워드】 Efficacy, Hospitalized, Tocilizumab, risk, database, clinical status, Retrospective study, Patient, Follow-up, multicenter, COVID-19 patients, CPAP, dose, observation, BiPAP, supplemental oxygen, Non-invasive, survival curve, control group, all-cause mortality, hazard, statistically significant difference, control groups, confounding factors, matching, Weighting, Effect, confounder, benefit, oxygen masks, defined, shown, evaluate, evaluated, conducted, were used, suggested, Ratio, Cerner, patients with COVID-19, subgroup of patient, TCZ, 【제목키워드】 assessment, Record, Result, the United State,