According to a recent study, tocilizumab does not appear to prevent the progression of the coronavirus disease 2019 (COVID-19) to critical disease, but it may still be useful in seriously unwell individuals when taken early in the inflammatory stage.
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A retrospective study was undertaken on 140
individuals with moderate to severe COVID-19, of whom 79 were administered
tocilizumab in varied standard doses (400 mg, 400–800 mg, >800 mg). The
medicine was given at three different stages: viral (1–7 days following
beginning of symptoms), early inflammatory (8–15 days), and late inflammatory
(16 days). Mortality, respiratory assistance needs, and inflammatory markers
were among the outcomes.
Individuals who got any additional dose of tocilizumab
had no significant improvement in mortality when compared to COVID-19 patients
who received standard treatment (enoxaparin + 6-mg dexamethasone once a day).
When the tocilizumab group was subdivided further
based on disease severity and medication administration timing, the researchers
discovered a substantial survival benefit among extremely ill patients who took
the therapy early in the inflammatory stage (4.1 percent versus 25.7 percent;
p=0.03). Those who received the 400–800 mg dose of tocilizumab had a similar
reduction in death risk (3.7 percent vs 25.7 percent; p=0.01).
"These findings show that COVID-19 may have a
broad clinical spectrum that is poorly understood, and that the efficacy of
tocilizumab may vary depending on the clinical presentation, and particularly
the COVID-19 stage." More research is needed to completely comprehend such
phenomena in order to tailor medication to various clinical presentations,
according to the researchers.
Source: Sci Rep 2021;11:19728