Effectiveness and safety of tocilizumab for COVID-19: a systematic review and meta-analysis of randomized clinical trials
São Paulo med. j
;
141(2): 168-176, Mar.-Apr. 2023. tab, graf
Artigo
em Inglês
|
LILACS-Express
| LILACS
| ID: biblio-1424661
ABSTRACT
ABSTRACT BACKGROUND:
Tocilizumab is an anti-human interleukin 6 receptor monoclonal antibody that has been used to treat coronavirus disease 2019 (COVID-19). However, there is no consensus on its efficacy for the treatment of COVID-19.OBJECTIVE:
To evaluate the effectiveness and safety of tocilizumab for treating COVID-19. DESIGN ANDSETTING:
Systematic Review of randomized controlled trials (RCTs), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.METHODS:
We searched MEDLINE via PubMed, EMBASE, CENTRAL, and IBECS for RCTs published up to March 2021. Two authors selected studies and assessed the risk of bias and the certainty of the evidence following Cochrane Recommendations.RESULTS:
Eight RCTs with 6,139 participants were included. We were not able to find differences between using tocilizumab compared to standard care on mortality in hospitalized patients with COVID-19 (risk ratio (RR) 0.97, 95% confidence interval (CI) 0.84 to 1.13; 8 trials; 5,950 participants; low-certainty evidence). However, hospitalized patients under tocilizumab plus standard care treatment seemed to present a significantly lower risk of needing mechanical ventilation (risk ratio = 0.78; 95% CI 0.64−0.94 moderate-certainty of evidence).CONCLUSIONS:
To date, the best evidence available shows no difference between using tocilizumab plus standard care compared to standard care alone for reducing mortality in patients with COVID-19. However, as a finding with a practical implication, the use of tocilizumab in association to standard care probably reduces the risk of progressing to mechanical ventilation in those patients. REGISTRATION osf.io/qe4fs.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Tipo de estudo:
Ensaio Clínico Controlado
/
Guia de Prática Clínica
/
Revisões Sistemáticas Avaliadas
Idioma:
Inglês
Revista:
São Paulo med. j
Assunto da revista:
Cirurgia Geral
/
Cincia
/
Ginecologia
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Medicina
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Ano de publicação:
2023
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Hospital Brasil, Rede DOR/BR
/
Universidade Federal de São Paulo (UNIFESP)/BR
/
Universidade Santo Amaro (UNISA)/BR
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