Tocilizumab Does Not Prevent Intubation, Death in COVID-19

26 March 2020, Mecklenburg-Western Pomerania, Schwerin: Ventilators and monitoring equipment are located in a room of the intensive care unit at the Helios Clinic. In the isolation wards, the doctors, nurses and staff wear protective suits, glasses and face masks. The Helios Klinikum is preparing for an increase in corona cases. Photo: Jens Büttner/dpa-Zentralbild/dpa (Photo by Jens Büttner/picture alliance via Getty Images)
Intubation or death, disease worsening similar for tocilizumab, placebo in hospitalized patients.

HealthDay News – For moderately ill hospitalized patients with COVID-19, tocilizumab is not effective for preventing intubation or death, according to a study published online October 21 in the New England Journal of Medicine.

John H. Stone, MD, MPH, from Massachusetts General Hospital in Boston, and colleagues conducted a randomized trial involving patients with confirmed severe acute respiratory syndrome coronavirus 2 infection, hyperinflammatory states, and at least 2 of: fever, pulmonary infiltrates, and need for supplemental oxygen to maintain oxygen saturation >92%. Two hundred forty-three patients were randomly assigned to receive either standard care plus a single dose of tocilizumab or placebo in a 2:1 ratio.

The researchers found that the hazard ratio for intubation or death was 0.83 (95% confidence interval, 0.38 to 1.81; P =.64) for tocilizumab vs placebo, and for disease worsening, the hazard ratio was 1.11 (95% confidence interval, 0.59 to 2.10; P =.73). At 14 days, 18.0 and 14.9% of patients in the tocilizumab and placebo groups, respectively, had had disease worsening. The median time to discontinuation of supplemental oxygen was 5.0 and 4.9 days in the tocilizumab and placebo groups, respectively (P =.69). At 14 days, 24.6 and 21.2% of patients receiving tocilizumab and placebo, respectively, were still receiving supplemental oxygen. Fewer serious infections occurred in patients receiving tocilizumab vs placebo.

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“We demonstrated very clearly that, for patients with the disease severity we studied, the use of IL-6 receptor blockade is not warranted,” Stone said in a statement.

The study was funded by Genentech, the manufacturer of tocilizumab.

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