Clinical effect of early administration of tocilizumab following the initiation of corticosteroid therapy for patients with COVID-19*

被引:2
作者
Kawamata, Takaya [1 ]
Tanino, Yoshinori [1 ,4 ]
Nikaido, Takefumi [1 ]
Minemura, Hiroyuki [1 ]
Sato, Yuki [1 ]
Togawa, Ryuichi [1 ]
Watanabe, Natsumi [1 ]
Yamada, Ryuki [1 ]
Sato, Riko [1 ]
Onuma, Takumi [1 ]
Tomita, Hikaru [1 ]
Saito, Mikako [1 ]
Rikimaru, Mami [1 ]
Suzuki, Yasuhito [1 ]
Tsukada, Yasuhiko [2 ]
Nakamura, Kiwamu [3 ]
Kanemitsu, Keiji [3 ]
Iseki, Ken [2 ]
Shibata, Yoko [1 ]
机构
[1] Dept Pulm Med, Fukushima, Japan
[2] Dept Emergency & Crit Care Med, Fukushima, Japan
[3] Fukushima Med Univ, Dept Infect Control, Hikarigaoka 1, Fukushima 9601295, Japan
[4] Fukushima Med Univ, Sch Med, 1 Hikarigaoka, Fukushima 9601295, Japan
关键词
Tocilizumab; Corticosteroids; COVID-19; SARS-CoV-2; METHYLPREDNISOLONE; DEXAMETHASONE; PNEUMONIA; BLOCKADE;
D O I
10.1016/j.jiac.2022.08.021
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first broke out in Wuhan in December 2019, and has since caused a global pandemic. The efficacy of several drugs has been evaluated, and it is now evident that tocilizumab has a beneficial effect, especially combined with corticosteroids, in patients with Coronavirus Disease 2019 (COVID-19). However, the optimal timing of tocilizumab administration has not yet been established. The goal of the present study was to determine the optimal timing of tocilizumab administration after starting corticosteroid therapy in patients with COVID-19. Methods: We retrospectively analyzed the clinical characteristics of patients who were hospitalized for COVID-19 and treated with tocilizumab and corticosteroids in our hospital. The patients were divided into concurrent and sequential groups. The concurrent group received tocilizumab <= 24 h after corticosteroids, and the sequential group received tocilizumab >24 h after corticosteroid administration. Results: The baseline clinical characteristics of tocilizumab administration were similar between the two groups. White blood cell counts were significantly lower and C-reactive protein levels were significantly higher in the concurrent group than the sequential group. In the concurrent group, tocilizumab administration led to a significant decrease in maximum body temperature. In addition, there were significantly more oxygen-free days in the concurrent group than in the sequential group. However, survival rate was not significantly different between the concurrent and the sequential groups. Conclusions: In the combination therapy with tocilizumab and corticosteroids, early administration of tocilizumab after starting corticosteroid treatment is effective when treating COVID-19.
引用
收藏
页码:1639 / 1644
页数:6
相关论文
共 32 条
[1]   Interleukin-6 receptor blockade in patients with COVID-19: placing clinical trials into context [J].
Angriman, Federico ;
Ferreyro, Bruno L. ;
Burry, Lisa ;
Fan, Eddy ;
Ferguson, Niall D. ;
Husain, Shahid ;
Keshavjee, Shaf H. ;
Lupia, Enrico ;
Munshi, Laveena ;
Renzi, Samuele ;
Ubaldo, Onion Gerald, V ;
Rochwerg, Bram ;
Del Sorbo, Lorenzo .
LANCET RESPIRATORY MEDICINE, 2021, 9 (06) :655-664
[2]   The conundrum of interleukin-6 blockade in COVID-19 [J].
Campochiaro, Corrado ;
Dagna, Lorenzo .
LANCET RHEUMATOLOGY, 2020, 2 (10) :E579-E580
[3]   Dexamethasone or methylprednisolone therapy in covid-19 pneumonia: A retrospective and comparative study of 513 cases [J].
El Mezzeoui, Sanae ;
El Aidouni, Ghizlane ;
Merbouh, Manal ;
El Kaouini, Abderrahim ;
Aftiss, Fatima Zahra ;
Berrichi, Samia ;
Berrajaa, Sara ;
Bkiyer, Houssam ;
Abda, Naima ;
Housni, Brahim .
ANNALS OF MEDICINE AND SURGERY, 2021, 70
[4]   Early Short-Course Corticosteroids in Hospitalized Patients With COVID-19 [J].
Fadel, Raef ;
Morrison, Austin R. ;
Vahia, Amit ;
Smith, Zachary R. ;
Chaudhry, Zohra ;
Bhargava, Pallavi ;
Miller, Joseph ;
Kenney, Rachel M. ;
Alangaden, George ;
Ramesh, Mayur S. .
CLINICAL INFECTIOUS DISEASES, 2020, 71 (16) :2114-2120
[5]   Comparison of efficacy of dexamethasone and methylprednisolone in moderate to severe covid 19 disease [J].
Fatima, Syeda Arzinda ;
Asif, Mohsin ;
Khan, Khurshid A. ;
Siddique, Nasir ;
Khan, Aijaz Zeeshan .
ANNALS OF MEDICINE AND SURGERY, 2020, 60 :413-416
[6]  
Gordon AC, 2021, NEW ENGL J MED, V384, P1491, DOI [10.1056/NEJMc2108482, 10.1056/NEJMoa2100433]
[7]   High serum IL-6 values increase the risk of mortality and the severity of pneumonia in patients diagnosed with COVID-19 [J].
Guirao, Jose J. ;
Cabrera, Carmen M. ;
Jimenez, Natalia ;
Rincon, Laura ;
Urra, Jose M. .
MOLECULAR IMMUNOLOGY, 2020, 128 :64-68
[8]   Effect of Tocilizumab vs Usual Care in Adults Hospitalized With COVID-19 and Moderate or Severe Pneumonia A Randomized Clinical Trial [J].
Hermine, Olivier ;
Mariette, Xavier ;
Tharaux, Pierre-Louis ;
Resche-Rigon, Matthieu ;
Porcher, Raphael ;
Ravaud, Philippe .
JAMA INTERNAL MEDICINE, 2021, 181 (01) :32-40
[9]  
Horby P, 2021, NEW ENGL J MED, V384, P693, DOI [10.1056/NEJMoa2022926, 10.1056/NEJMoa2021436]
[10]  
Horby PW, 2021, LANCET, V397, P1637, DOI 10.1016/S0140-6736(21)00676-0