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• W3128388571 abstract "Abstract Background: Cytokine storm is the main cause of mortality in COVID-19. Tocilizumab, an IL-6 inhibitor, is being tested for its therapeutic potential in this condition. To evaluate the efficacy and safety of Tocilizumab in comparison to Standard therapy in the treatment of COVID-19 in adult patients. Methods: Using Medline (via PubMed), The Cochrane Central Register of Controlled Trials, preprint server (medRxiv) and clinicaltrials.gov, a final search was conducted on 26 th June 2020. All types of clinical studies (prospective or retrospective cohort studies, observational case-control studies, clinical trials) aiming to evaluate the role of Tocilizumab in the treatment of patients with COVID-19 were considered eligible for this systematic review. Tocilizumab was considered as the intervention group and standard of care or drugs other than tocilizumab as control group. Meta-analysis was performed by Cochrane review manager 5 (RevMan) version 5.3. For quality assessment, ROBINS-I (The Risk Of Bias In Non-randomised studies – of Interventions) assessment tool for observational studies was used. The overall quality of evidence for each of the outcomes was assessed using the GRADE Pro GDT. Results: Out of 362 records identified, 13 studies were included in qualitative and quantitative analysis. Tocilizumab treatment was associated with 46% decrease in probability of mortality rate [Adjusted HR = 0.54 (95% CI = 0.44-0.68), p<0.00001; I2=74%] and 66% odds decrease in progression of disease [OR = 0.34 (95% CI = 0.21 – 0.55), p<0.0001; I 2 =76%] compared to control. However, there was no difference in hospital discharge [OR = 1.35 (95% CI = 0.84 – 2.18), p=0.22; I 2 =22%] and clinical improvement [OR = 1.02 (95% CI = 0.61 – 1.69), p=0.95; I2=84%] with tocilizumab. There was statistically significant increase in risk of secondary bacteraemia [OR = 2.75 (95% CI = 1.86 – 4.06), p< 0.00001] and superinfections [OR = 2.93 (95% CI = 1.92 – 4.46), p< 0.00001]. Conclusions: With current evidence on efficacy and safety of tocilizumab, we recommend use of tocilizumab treatment for moderate to severe COVID-19 patients caused by SARS-CoV-2, along with caution for superinfections. Systematic review registration: PROSPERO registration number: CRD42020189517" @default.
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• W3128388571 date "2020-08-25" @default.
• W3128388571 modified "2023-09-23" @default.
• W3128388571 title "Efficacy and Safety of Tocilizumab in the Treatment of SARS-CoV-2: A Systematic Review and Meta-analysis" @default.
• W3128388571 doi "https://doi.org/10.21203/rs.3.rs-59511/v1" @default.
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