Experience with the use of siltuximab in patients with SARS-CoV-2 infection

Meira, Fernanda; Albiach, Laia; Carbonell, Cristina; Martín-Oterino, José-Ángel; Martín-Ordiales, Mercedes; Linares, Laura; Macaya, Irene; Agüero, Daiana; Ambrosioni, Juan; Bodro, Marta; Cardozo, Celia; Chumbita, Mariana; De la Mora, Lorena; García-Pouton, Nicole; Garcia-Vidal, Carolina; González-Cordón, Ana; Hernández-Meneses, Marta; Inciarte, Alexy; Laguno, Montserrat; Leal, Lorna; Morata, Laura; Puerta-Alcalde, Pedro; Rico, Verónica; Letona, Laura; Cózar-Llistó, Alberto; Dueñas, Gerard; Solá, Montserrat; Torres, Berta; Rojas, Jhon; Moreno, Antonio; Moreno-García, Estela; Torres, Manuel; Martínez, José A; Soriano, Alex; García, Felipe

OBJECTIVES: The study aims to describe characteristics and clinical outcome of patients with SARS-CoV-2 infection that received siltuximab according to a protocol that aimed to early block the activity of IL-6 to avoid the progression of the inflammatory flare. PATIENTS AND METHODS: Retrospective review of the first 31 patients with SARS-CoV-2 treated with siltuximab, in Hospital Clinic of Barcelona or Hospital Universitario Salamanca, from March to April 2020 with positive polymerase-chain reaction (PCR) from a nasopharyngeal swab. RESULTS: The cohort included 31 cases that received siltuximab with a median (IQR) age of 62 (56-71) and 71% were males. The most frequent comorbidity was hypertension (48%). The median dose of siltuximab was 800 mg ranging between 785 and 900 mg. 7 patients received siltuximab as a salvage therapy after one dose of tocilizumab. At the end of the study, a total of 26 (83.9) patients had been discharged alive and the mortality rate was 16.1% but only 1 out of 24 that received siltuximab as a first line option (4%). CONCLUSIONS: Siltuximab is a well-tolerated alternative to tocilizumab when administered as a first line option in patients with COVID-19 pneumonia within the first 10 days from symptoms onset and high C-reactive protein.