Find in Library
Search millions of books, articles, and more
Indexed Open Access Databases
Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
oleh: Miguel Górgolas Hernández-Mora, Alfonso Cabello Úbeda, Laura Prieto-Pérez, Felipe Villar Álvarez, Beatriz Álvarez Álvarez, María Jesús Rodríguez Nieto, Irene Carrillo Acosta, Itziar Fernández Ormaechea, Aws Waleed Mohammed Al-Hayani, Pilar Carballosa, Silvia Calpena Martínez, Farah Ezzine, Marina Castellanos González, Alba Naya, Marta López De Las Heras, Marcel José Rodríguez Guzmán, Ana Cordero Guijarro, Antonio Broncano Lavado, Alicia Macías Valcayo, Marta Martín García, Javier Bécares Martínez, Ricardo Fernández Roblas, Miguel Ángel Piris Pinilla, José Fortes Alen, Olga Sánchez Pernaute, Fredeswinda Romero Bueno, Sarah Heili-Frades, Germán Peces-Barba Romero
Format: | Article |
---|---|
Diterbitkan: | Elsevier 2021-01-01 |
Deskripsi
Introduction: Tocilizumab (TCZ) is an interleukin-6 receptor antagonist, which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), which aims to ameliorate the cytokine release syndrome (CRS) induced acute respiratory distress syndrome (ARDS). However, there are no consistent data about who might benefit most from it. Methods: We administered TCZ on a compassionate-use basis to patients with SSP who were hospitalized (excluding intensive care and intubated cases) and who required oxygen support to have a saturation >93%. The primary endpoint was intubation or death after 24 h of its administration. Patients received at least one dose of 400 mg intravenous TCZ from March 8, 2020 to April 20, 2020. Results: A total of 207 patients were studied and 186 analyzed. The mean age was 65 years and 68% were male patients. A coexisting condition was present in 68% of cases. Prognostic factors of death were older age, higher IL-6, d-dimer and high-sensitivity C-reactive protein (HSCRP), lower total lymphocytes, and severe disease that requires additional oxygen support. The primary endpoint (intubation or death) was significantly worst (37% vs 13%, p < 0·001) in those receiving the drug when the oxygen support was high (FiO2 >0.5%). Conclusions: TCZ is well tolerated in patients with SSP, but it has a limited effect on the evolution of cases with high oxygen support needs.