Effect of interleukin-6 receptor antagonists in critically ill adult patients with COVID-19 pneumonia: two randomised controlled trials of the CORIMUNO-19 Collaborative Group.


Journal

The European respiratory journal
ISSN: 1399-3003
Titre abrégé: Eur Respir J
Pays: England
ID NLM: 8803460

Informations de publication

Date de publication:
08 2022
Historique:
received: 25 06 2021
accepted: 23 12 2021
pubmed: 5 2 2022
medline: 13 8 2022
entrez: 4 2 2022
Statut: epublish

Résumé

Our objective was to determine whether anti-interleukin (IL)-6 receptors improve outcomes of critically ill patients with coronavirus disease 2019 (COVID-19) pneumonia. We report on two cohort-embedded, investigator-initiated, multicentre, open-label, Bayesian randomised controlled clinical trials. Patients were randomly assigned to receive either usual care (UC) or UC+tocilizumab (TCZ) 8 mg·kg Between 31 March and 20 April 2020, 97 patients were randomised in the TOCI-2 trial, to receive UC (n=46) or UC+TCZ (n=51). At day 14, numbers of patients who did not need noninvasive ventilation (NIV) or mechanical ventilation (MV) and were alive with TCZ or UC were similar (47% In critically ill patients with COVID-19, anti-IL-6 receptors did not significantly increase the number of patients alive without any NIV or MV by day 14.

Sections du résumé

BACKGROUND
Our objective was to determine whether anti-interleukin (IL)-6 receptors improve outcomes of critically ill patients with coronavirus disease 2019 (COVID-19) pneumonia. We report on two cohort-embedded, investigator-initiated, multicentre, open-label, Bayesian randomised controlled clinical trials.
METHODS
Patients were randomly assigned to receive either usual care (UC) or UC+tocilizumab (TCZ) 8 mg·kg
RESULTS
Between 31 March and 20 April 2020, 97 patients were randomised in the TOCI-2 trial, to receive UC (n=46) or UC+TCZ (n=51). At day 14, numbers of patients who did not need noninvasive ventilation (NIV) or mechanical ventilation (MV) and were alive with TCZ or UC were similar (47%
CONCLUSION
In critically ill patients with COVID-19, anti-IL-6 receptors did not significantly increase the number of patients alive without any NIV or MV by day 14.

Identifiants

pubmed: 35115337
pii: 13993003.02523-2021
doi: 10.1183/13993003.02523-2021
pmc: PMC8819469
pii:
doi:

Substances chimiques

Receptors, Interleukin-6 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright ©The authors 2022.

Déclaration de conflit d'intérêts

Conflict of interest: P-L. Tharaux has received honoraria for participation on advisory boards for Travere therapeutics. All other author disclose no potential conflicts of interest related to this work.

Auteurs

Olivier Hermine (O)

Dépt d'Hématologie, Hôpital Necker, AP-HP, Université de Paris, Paris, France ohermine@gmail.com.
Laboratory of Physiopathology and Treatment of Haematological Malignancies, Institut Imagine, INSERM U1153, Université de Paris, Paris, France.
All authors contributed equally.

Xavier Mariette (X)

Dépt de Rhumatologie, Hôpital Bicêtre, AP-HP, Université de Paris Sud, Paris, France.
All authors contributed equally.

Raphael Porcher (R)

Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), INSERM/Université Paris, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Paris, France.
All authors contributed equally.

Matthieu Resche-Rigon (M)

Service de Biostatistique et Information Médicale, INSERM U153, Hôpital Saint Louis, AP-HP, Université de Paris, Paris, France.
All authors contributed equally.

Pierre-Louis Tharaux (PL)

INSERM U970 Paris Cardiovascular Centre (PARCC), Université de Paris, Paris, France.
All authors contributed equally.

Philippe Ravaud (P)

Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), INSERM/Université Paris, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Paris, France.
All authors contributed equally.
The Writing Committee is listed in the Acknowledgements section at the end of the article, and the Steering Committee and a complete list of CORIMUNO-19 investigators are provided in the supplementary appendix.

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