Interleukin-6 blockade for severe COVID-19

Mathilde ROUMIER; Romain PAULE; Matthieu GROH; Alexandre VALLEE; Felix ACKERMANN

(which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.20.20061861 doi: medRxiv preprint 3 Tocilizumab is mainly used worldwide for the treatment of rheumatoid arthritis, but other indications include refractory giant cell arthritis, idiopathic multicentric Castleman disease, and chimeric antigen receptor T-cell therapy-induced cytokine release syndrome (a condition that to some extent can mimic the clinical picture of COVID-19induced ARDS) (6) . In the emergency context of the COVID-19 epidemic in France, an offlabel compassionate-use program of intravenous tocilizumab (8 mg/kg at the discretion of treating physicians, renewable once in case of insufficient response to therapy) was started at Foch university hospital (Suresnes, France) for selected COVID-19 patients (per WHO criteria) of less than 80 years of age with severe (i.e. requiring >6L/min of oxygen therapy) rapidly deteriorating (i.e. increase by ≥3L/min of oxygen flow within the previous 12 hours) pneumonia, high C-reactive protein levels and with ≥5 days of prior disease duration. All patients provided informed consent prior to receiving tocilizumab and this program was approved by the local Institutional Review Board (approval number: IRB00012437).