A new systematic review and meta-analysis has concluded that tocilizumab should not be recommended for the treatment of severe COVID-19.
The review included seven retrospective studies, involving 593 adults with severe COVID-19 receiving tocilizumab (n=241) or anti-IL-6 and its comparators (n=352).
All-cause mortality among severe COVID-19 patients was 16.2 per cent (39/241) for tocilizumab and 24.1 per cent (85/352) for controls. However, the difference did not reach statistical significance (risk ratio [RR] 0.61; 95% CI 0.31-1.22; I2=68%).
The risk of admission to intensive care was similar between the tocilizumab and control groups (35.0% vs. 15.8%, RR 1.51; 95% CI 0.33-6.78, I2=86%).
The requirement of mechanical ventilation was similar between the tocilizumab and control groups (32.4% vs. 28.6%, RR, 0.72; 95% CI, 0.05-10.96, I2 = 91%). The authors say these non-significant differences between the tocilizumab and control groups may have been the result of the baseline characteristics of the tocilizumab group, which were more severe than those of the control group.
The authors concluded that there is no conclusive evidence that tocilizumab would provide any additional benefit to patients with severe COVID-19.
Therefore, they said, further recommendation of tocilizumab for COVID-19 cases should be halted until high-quality evidence from randomized controlled trials is made available.