Author: Hernández-Mora, Miguel Górgolas; Cabello Úbeda, Alfonso; Pérez, Laura Prieto; Ãlvarez, Felipe Villar; Ãlvarez, Beatriz Ãlvarez; RodrÃguez Nieto, MarÃa Jesús; Acosta, Irene Carrillo; Ormaechea, Itziar Fernández; Al-Hayani, Aws Waleed Mohammed; Carballosa, Pilar; MartÃnez, Silvia Calpena; Ezzine, Farah; González, Marina Castellanos; Naya, Alba; de las Heras, Marta López; RodrÃguez Guzmán, Marcel José; Guijarro, Ana Cordero; Lavado, Antonio Broncano; Valcayo, Alicia MacÃas; GarcÃa, Marta MartÃn; MartÃnez, Javier Bécares; Roblas, Ricardo Fernández; Piris Pinilla, Miguel Ãngel; Alen, José Fortes; Pernaute, Olga Sánchez; Bueno, Fredeswinda Romero; Frades, Sarah Heili; Romero, Germán Peces Barba
Title: Compassionate Use of Tocilizumab in Severe SARS-CoV2 Pneumonia Cord-id: 5mrkmctl Document date: 2020_10_25
ID: 5mrkmctl
Snippet: INTRODUCTION: Tocilizumab is an interleukin 6 receptor antagonist which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), aiming to ameliorate the cytokine release syndrome (CRS) -induced acute respiratory distress syndrome (ARDS). However, there are no consistent data whom might benefit most from it. METHODS: We provided tocilizumab on a compassionate-use basis to patients with SSP hospitalized (excluding intensive care and intubated cases) who required oxygen support to hav
Document: INTRODUCTION: Tocilizumab is an interleukin 6 receptor antagonist which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), aiming to ameliorate the cytokine release syndrome (CRS) -induced acute respiratory distress syndrome (ARDS). However, there are no consistent data whom might benefit most from it. METHODS: We provided tocilizumab on a compassionate-use basis to patients with SSP hospitalized (excluding intensive care and intubated cases) who required oxygen support to have a saturation >93%. Primary endpoint was intubation or death after 24 hours of its administration. Patients received at least one dose of 400 mg intravenous tocilizumab during March 8-2020, through April 20-2020. RESULTS: A total of 207 patients were studied and 186 analysed. The mean age was 65 years and 68% were male. A co-existing condition was present in 68 % of cases. Death prognostic factors were older age, higher IL-6, D-dimer and high sensitivity C reactive protein (HSCRP), lower total lymphocytes and severe disease requiring higher 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: Tocilizumab is well tolerated in patients with severe SARS-CoV-2 pneumonia, but it has a limited effect on the evolution of cases with high oxygen support needs.
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