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Efficacy of tocilizumab in COVID‐19: A systematic review and meta‐analysis
Author(s) -
Aziz Muhammad,
Haghbin Hossein,
Abu Sitta Emad,
Nawras Yusuf,
Fatima Rawish,
Sharma Sachit,
LeeSmith Wade,
Duggan Joan,
Kammeyer Joel A.,
Hanrahan Jennifer,
Assaly Ragheb
Publication year - 2021
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.26509
Subject(s) - tocilizumab , medicine , mechanical ventilation , meta analysis , confidence interval , intensive care unit , covid-19 , randomized controlled trial , strictly standardized mean difference , subgroup analysis , relative risk , disease , infectious disease (medical specialty)
The efficacy of tocilizumab (TOC), monoclonal antibody against interleukin‐6 (IL‐6) receptor, in patients with coronavirus disease‐2019 (COVID‐19) patients has led to conflicting results. We performed a systematic review and meta‐analysis to compare the efficacy of addition of TOC to standard of care (SOC) versus SOC in patients with COVID‐19. We performed a comprehensive literature search of PubMed, Embase, Web of Science, WHO COVID, LitCOVID, and Cochrane databases. Pooled outcomes (overall mortality, need for mechanical ventilation, intensive care unit admission, and secondary infections) were compared using DerSimonian‐Laird/Random‐effects approach. Risk difference (RD), confidence interval (CI), and p values were generated. A total of 23 studies with 6279 patients (1897 in TOC and 4382 in SOC group, respectively) were included. The overall mortality was lower in TOC group compared to SOC group (RD: −0.06; CI: −0.12 to −0.01; p = .03). Subgroup analysis including studies with only severe cases revealed lower mortality (RD: −0.12; CI: −0.18 to −0.06; p < .01) and need for mechanical ventilation (RD: −0.11; CI: −0.19 to −0.02; p = .01) in TOC group compared to SOC group. The addition of TOC to SOC has the potential to reduce mortality and need for mechanical ventilation in patients with severe COVID‐19. Randomized controlled trials are needed to validate this.