- A compassionate use study of tocilizumab, an inhibitor of IL-6, finds reduced inflammation from cytokine storm and low mortality in mostly intubated patients with SARS-CoV-2 pneumonia.
Why this matters
- SARS-CoV-2 pneumonia is linked to high mortality, and treatments are limited.
- The cytokine storm that tocilizumab targets appears to increase morbidity and mortality.
- Single-center consecutive case series of mostly intubated patients (21 of 27 total) hospitalized with SARS-CoV-2 pneumonia.
- Patients with confirmed SARS-CoV-2 infection and pneumonia were given a single dose of intravenous tocilizumab 400 mg.
- Funding: None.
- IL-6 was the predominant cytokine (mean, 356.07±616 pg/mL vs normal 0-5 pg/mL; P<.001>
- C-reactive protein (CRP) levels were reduced within 72 hours of treatment (pretocilizumab median 160 mg/L vs posttocilizumab median 20 mg/L; P<.001>
- 3 of 4 patients not showing rapid declines in CRP had poor outcomes.
- Requirements for oxygen and vasopressor decreased over the first week posttocilizumab.
- Of the 21 patients who required mechanical ventilation, 15 (71%) were extubated over a median of 8 days posttreatment, and 9 (43%) were discharged over the study period.
- Only 2 (10%) intubated patients died, unrelated to tocilizumab therapy.
- Only minimal adverse events and serious adverse events were seen.
- Single-center study with small sample size.
- No control group.