Tocilizumab Therapy Doesn't Improve Outcomes in Moderately Ill Hospitalized COVID-19 Patients
In This Article
- COVID-19 patients with elevated levels of interleukin-6 (IL-6) have a greater need for mechanical ventilation and a greater risk of dying
- Earlier research suggested that tocilizumab, an IL-6 blocker often prescribed for rheumatoid arthritis, might be able to treat patients with worsening COVID-19
- A Massachusetts General led clinical trial found that tocilizumab did not reduce the need for mechanical ventilation or prevent death in moderately ill, hospitalized COVID-19 patients
- Patients treated with tocilizumab or placebo were just as likely to require intubation or die over a four-week period. The conditions of patients in both groups similarly improved or worsened
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It is known that COVID-19 patients with elevated levels of cytokine interleukin-6 (IL-6) have a greater need for mechanical ventilation and a greater risk of dying. A few studies early in the pandemic suggested that tocilizumab, an IL-6 blocker often prescribed for rheumatoid arthritis, might be able to treat patients with worsening COVID-19, but none were randomized, double-blind, placebo-controlled.
A new clinical trial called the Boston Area COVID-19 Consortium (BACC) Bay Tocilizumab Trial, led by principal investigator John H. Stone, MD, MPH, director of the Rheumatology Unit and the Edward A. Fox chair in Medicine at Mass General, found that tocilizumab did not reduce the need for mechanical ventilation or prevent death in moderately ill, hospitalized COVID-19 patients. The report is published in the New England Journal of Medicine.
The trial evaluated 243 hospitalized patients with moderately severe COVID-19 and high levels of inflammation and two symptoms of pneumonia, low blood-oxygen levels and fever. Two-thirds of patients were given an infusion of tocilizumab, and one-third were given a placebo, in addition to standard care. The primary outcome goal was whether tocilizumab prevented patients from ever requiring intubation or dying.
The results were that patients treated with tocilizumab or placebo were just as likely to require intubation or die over a four-week period. The conditions of patients in both groups improved or worsened similarly.
Dr. Stone noted that this study clearly demonstrated that the use of IL-6 in this patient population is "not warranted."
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