TOCILIZUMAB


DrugBank ID: db06273
DrugCentral: tocilizumab
Synonymous :atlizumab



Drug Sentece Context


Table 1. Analysis of context sentence of tocilizumab gene in 135 abstracts.

pmid sentence
32222713 He remained in critical condition being treated with hydroxychloroquine and tocilizumab in addition to the standard medical management for septic shock and ARDS.
32234467 Tocilizumab is a blocker of IL-6R, which can effectively block IL-6 signal transduction pathway. […] So, tocilizumab is likely to become an effective drug for patients with severe COVID-19.
32240462 The efficacy of some promising antivirals, convalescent plasma transfusion, and tocilizumab needs to be investigated by ongoing clinical trials.
32243270 This review summarizes the current evidence of potential therapeutic agents, such as lopinavir/ritonavir, remdesivir, favipiravir, chloroquine, hydroxychloroquine, interferon, ribavirin, tocilizumab and sarilumab.
32247050 Potential treatments included remdesivir, chloroquine, tocilizumab, convalescent plasma and vaccine immunization (when possible).
32253068 Anti-IL-1 and anti-IL-6 may interfere with the cytokine storm in severe cases and use of tocilizumab has shown good outcomes in a small cohort.
32253759 Tocilizumab (TCZ), a monoclonal antibody against interleukin-6 (IL-6), emerged as an alternative treatment for COVID-19 patients with a risk of cytokine storms recently.
32275256 Lastly, a collaborating group with immunologists and rheumatologists has been built with the aim of providing some guidance about the use of tocilizumab, a promising option for the treatment of the hyperinflammatory state occurring in most patients affected by COVID-19.
32277367 • Although preliminary results may be encouraging, high-quality clinical trials are needed to better understand the role of drugs commonly used in rheumatology like hydroxychloroquine and tocilizumab in COVID-19.
32282982 Hydroxychloroquine (HCQ) was used by 78.1% of respondents; azithromycin by 46.9%; tocilizumab by 31.3%, and remdesivir by 25.0%.
32290839 Moreover, Tocilizumab treatment that blocking IL-6 receptors showed inspiring clinical results including temperature returned to normal quickly and respiratory function improved. […] Therefore, we suggest that Tocilizumab is an effective treatment in severe patients of COVID-19 to calm the inflammatory storm and reduce mortality.
32297987 The use of humanized anti-human inteleukine-6 receptor antibody tocilizumab seems a promising strategy for these patients.
32298807 Specifically, we address (1) necessary resources for safe administration of cell therapies; (2) determinants of cell therapy utilization; (3) selection among patients with B cell non-Hodgkin lymphomas and B cell acute lymphoblastic leukemia; (4) supportive measures during cell therapy administration; (5) use and prioritization of tocilizumab; and (6) collaborative care with referring physicians.
32305359 Expanded indications for hydroxychloroquine and tocilizumab have already caused stress on the usual supply chain.
32314799 Tocilizumab is an interleukin-6 (IL-6) receptor antibody and is progressing as a viable and promising treatment option in patients with severe coronavirus disease 2019 (COVID-19). […] In this letter we outline two cases of acute hypertriglyceridemia in patients with COVID-19 treated with tocilizumab: one with elevated biomarkers consistent with acute pancreatitis the other without. […] Clinicians should consider monitoring for hypertriglyceridemia and acute pancreatitis as described with chronic tocilizumab use for rheumatoid arthritis in those receiving it for COVID-19.
32317557 Adjunctive medication in the surviving patients while on ECMO was as follows: 4 of 5 survivors received intravenous steroids, 3 of 5 survivors received antiviral medications (Remdesivir), 2 of 5 survivors were treated with anti-interleukin-6-receptor monoclonal antibodies (Tocilizumab or Sarilumab), and 1 of 5 survivors received hydroxychloroquine.An analysis of 32 COVID-19 patients with severe pulmonary compromise supported with ECMO suggests that ECMO may play a useful role in salvaging select critically ill patients with COVID-19.
32320677 SARS-CoV-2 patient plasma inhibited HLA-DR expression, and this was partially restored by the IL-6 blocker Tocilizumab; off-label Tocilizumab treatment of patients was accompanied by increase in circulating lymphocytes.
32324331 We describe the case of a 61-year-old kidney transplant recipient with several comorbidities who was hospitalized and later received a diagnosis of COVID-19 pneumonia; the infection was successfully managed with the use of hydroxychloroquine and a single administration of tocilizumab, after immunosuppression reduction; the patient did not require mechanical ventilation.
32329520 Drug repositioning may offer a strategy and a number of drugs have been repurposed, including lopinavir/ritonavir, remdesivir, favipiravir and tocilizumab.
32329879 However, the current treatment options include hydroxychloroquine, tocilizumab, remdesivir, lopinavir-ritonavir (Kaletra®), and nitazoxanide.
32330343 Among the 68 hospitalized patients, 12% required non-rebreather and 35% required intubation. 91% received hydroxychloroquine, 66% azithromycin, 3% remdesivir, 21% tocilizumab, and 24% bolus steroids.
32330817 Patients also received lopinivir/ritonavir (82%), hydroxychloroquine (79%), and tocilizumab (12%) according to this treatment algorithm.
32337664 Tocilizumab, which is the IL-6 receptor antagonist, has been approved by the US FDA for the treatment of cytokine release syndrome (CRS), is expected to treat cytokine storm caused by COVID-19 and is now in clinical trials. […] In this paper, we will elaborate the role of cytokine storm in COVID-19, the mechanism of tocilizumab on cytokine storm and the key points of pharmaceutical care based on the actual clinical application for COVID-19 in our hospital, the latest research reports, clinical trial progress of tocilizumab, drug instruction from the US FDA, and “Diagnosis and Treatment Plan of Novel Coronavirus Pneumonia (seventh trial edition)” in China, so as to provide reference for the treatment of COVID-19.
32339832 Without much experience, currently, the medicines that are clinically being evaluated for COVID-19 include chloroquine, hydroxychloroquine, azithromycin, tocilizumab, lopinavir, ritonavir, tocilizumab and corticosteroids.
32341791 Here we discuss the challenges that patients with autoimmune diseases might face and the information on using immunomodulatory therapies like chloroquine, tocilizumab and baricitinib to quench the cytokine storm in patients with very severe COVID-19 pneumonia.
32343413 We read with interest the article by Morrison et al. on acute hypertriglyceridemia secondary to tocilizumab in patients with severe COVID-19. […] Both patients were already on lopinavir/ritonavir before tocilizumab (added day 9 and day 13) was added.
32343429 Our study should encourage researchers to conduct trial evaluating Anti IL-6 antibodies such as Tocilizumab to assess the efficacy in patients with severe COVID-19.
32343968 Anti-cytokine therapy such as tocilizumab, an IL-6 receptor antagonist, is a potential treatment for COVID-19; however, data regarding the efficacy of this anti-IL-6 therapy are currently lacking. […] We report two cases of patients who received a diagnosis of COVID-19 complicated by CRS and were treated with tocilizumab. […] Both patients progressed to sHLH despite treatment with tocilizumab, and one developed viral myocarditis, challenging the safety and clinical usefulness of tocilizumab in the treatment of COVID-19-induced CRS. […] These cases highlight the need for clinical trials to determine optimal patient selection and timing for the use of tocilizumab during this disease process.
32350134 Here, we aimed to assess the efficacy of tocilizumab in severe patients with COVID-19 and seek a therapeutic strategy. […] The patients diagnosed as severe or critical COVID-19 in The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) and Anhui Fuyang Second People’s Hospital were given tocilizumab in addition to routine therapy between 5 and 14 February 2020. […] Within 5 d after tocilizumab, 15 of the 20 patients (75.0%) had lowered their oxygen intake, and 1 patient needed no oxygen therapy. […] All patients have been discharged on average 15.1 d after giving tocilizumab. […] Preliminary data show that tocilizumab, which improved the clinical outcome immediately in severe and critical COVID-19 patients, is an effective treatment to reduce mortality.
32352535 Cardiovascular considerations of therapies currently used, including remdesivir, chloroquine, hydroxychloroquine, tocilizumab, ribavirin, interferons, and lopinavir/ritonavir, as well as experimental therapies, such as human recombinant ACE2 (rhACE2), are discussed.
32352944 The administration of glucocorticosteroids and research drugs (tocilizumab) is acceptable for massive infiltrative lesions in the pulmonary parenchyma causing severe lung injury (ALI) and acute respiratory distress syndrome (ARDS).
32353742 There is anecdotal evidence that tocilizumab, an immunosuppressant drug, may be a potential therapeutic option for patients with severe manifestations of coronavirus disease 2019 (COVID-19). […] Like tocilizumab, Vitamin D appears to modulate the activity of an interleukin (IL-6), which may explain the seasonal variation in prevalence of influenza. […] This would be far cheaper and simpler than tocilizumab as a therapeutic option to trial.
32354634 Six of 12 patients were treated with tocilizumab, a humanized monoclonal antibody to the IL-6 receptor.
32359035 We conducted a pilot prospective open, single-arm multicentre study on off-label use of tocilizumab (TCZ) involving 63 hospitalised adult patients (56 males, age 62.6±12.5) with severe COVID-19.
32359210 We report the clinical course and management of a liver transplant recipient on hemodialysis, who presented with COVID-19 pneumonia, and despite completing a 5-day course of hydroxychloroquine, later developed marked inflammatory manifestations with rapid improvement after administration of off-label, single-dose tocilizumab.
32367812 He developed respiratory failure and was transferred to the intensive care unit where he received further treatment, including tocilizumab (IL-6 receptor inhibitor).
32369191 Tocilizumab, an interleukin-6 inhibitor, may ameliorate the inflammatory manifestations associated with severe coronavirus disease 2019 (COVID-19) and thus improve clinical outcomes. […] This was a retrospective review of patients with laboratory-confirmed severe COVID-19 who received tocilizumab and completed 14 days of follow up. […] The proportion of patients on invasive ventilation declined from (84%) at the time of tocilizumab initiation to 60% on day 7 (P = .031) and 28% on day 14 (P = .001). […] However, it is not possible to ascertain which adverse events were directly related to tocilizumab therapy. […] In patients with severe COVID-19, tocilizumab was associated with dramatic decline in inflammatory markers, radiological improvement and reduced ventilatory support requirements.
32371479 Early reports suggest that tocilizumab, an IL6 receptor-blocking antibody used to manage toxicities associated with chimeric antigen receptor T-cell therapy, may help control cytokine storms in people infected with COVID-19.
32373721 Blocking IL-6 with tocilizumab and using respirator equipment seems to be a very important issue in this (SARS-CoV-2) pneumonia, but not all patients are referred to such treatments.
32376395 In this cross-sectional study, Tuscan outpatients with systemic autoimmune diseases followed at a tertiary referral centre were telephonically interviewed between April 1st-14th 2020 to collect demographic and clinical data, information on ongoing immunomodulating/immunosuppressive treatments, and on the presence of symptoms suspected of SARS-CoV-2 or of a confirmed infection. 458 patients were interviewed [74% female, median age 56 years (IQR 43-68)]; 56% of them were receiving corticosteroids, 44% traditional disease-modifying anti-rheumatic drugs (DMARDs), of whom 23% hydroxychloroquine, 5% colchicine, while 41% were on biologic DMARDs (of whom 9% on tocilizumab).
32376398 A prospective series of 100 consecutive patients admitted to the Spedali Civili University Hospital in Brescia (Italy) between March 9th and March 20th with confirmed COVID-19 pneumonia and ARDS requiring ventilatory support was analyzed to determine whether intravenous administration of tocilizumab (TCZ), a monoclonal antibody that targets the interleukin 6 (IL-6) receptor, was associated with improved outcome. […] Tocilizumab was administered at a dosage of 8 mg/kg by two consecutive intravenous infusions 12 h apart. […] The outcome measure was an improvement in acute respiratory failure assessed by means of the Brescia COVID Respiratory Severity Score (BCRSS 0 to 8, with higher scores indicating higher severity) at 24-72 h and 10 days after tocilizumab administration.
32378314 Despite reduction in immunosuppression and treatment with tocilizumab, intravenous immunoglobulin, hydroxychloroquine, lopinavir/ritonavir, and broad-spectrum antibiotics, she ultimately died from multiorgan failure. […] Because of a lack of clinical improvement several days later, tocilizumab, methylprednisolone, and therapeutic anticoagulation were initiated.
32378647 Interleukin 6 (IL-6) inhibitor (tocilizumab) had been suggested for the treatment of acute respiratory distress syndrome (ARDS) patients based on the concept of “cytokine storm” in COVID-19.
32387320 Tocilizumab (TCZ) in patients with severe COVID-19 could be an effective treatment.
32391669 To observe the clinical effect of plasma exchange and tocilizumab in treatment of patients with severe coronavirus disease 2019 (COVID-19). […] Three patients were treated with plasma exchange and three patients were treated with tocilizumab. […] The effect on excessive inflammatory reaction of plasma exchange and tocilizumab was observed. […] The C-reactive protein (CRP) and IL-6 levels were significantly decreased and the lymphocyte and prothrombin time were improved in 3 patients after treatment with plasma exchange; while inflammation level was not significantly decreased, and lymphocyte and prothrombin time did not improve in 3 patients treated with tocilizumab.
32392389 One patient treated with tocilizumab for COVID-19 was successfully extubated.
32397399 Objective: This study aimed to assess the role of Tocilizumab therapy (TCZ) in terms of ICU admission and mortality rate of critically ill patients with severe COVID-19 pneumonia. Design: Patients with COVID-19 pneumonia were prospectively enrolled in SMAtteo COvid19 REgistry (SMACORE). […] The first administration was 8 mg/kg (up to a maximum 800 mg per dose) of Tocilizumab intravenously, repeated after 12 h if no side effects were reported after the first dose. Main Outcomes and Measures: ICU admission and 7-day mortality rate.
32397911 In particular, hydroxychloroquine, remdesivir, favipiravir, arbidol, tocilizumab and bevacizumab have shown promising results.
32399455 We present a case of life-threatening CRS caused by COVID-19 infection with a favourable response to immunosuppressive therapy with tocilizumab (TCZ). […] Cytokine release syndrome may cause sudden and potentially life-threatening clinical deterioration in COVID-19 pneumonia, particularly in younger patients.Immunosuppressive therapy may provide important additional therapeutic benefit in these patients.Tocilizumab, a specific IL-6 inhibitor, led to dramatic clinical improvement in a young patient with severe COVID-19-associated cytokine release syndrome.
32405160 This study aims to evaluate if tocilizumab, an anti-soluble IL-6 receptor monoclonal antibody, reduces patients’ mortality. 85 consecutive patients admitted to the Montichiari Hospital (Italy) with COVID-19 related pneumonia and respiratory failure, not needing mechanical ventilation, were included if satisfying at least one among: respiratory rate ≥ 30 breaths/min, peripheral capillary oxygen saturation ≤ 93% or PaO2/FiO2<=300 mmHg. […] On March 13th tocilizumab was available and patients admitted thereafter (n=62) received tocilizumab once within 4 days from admission, plus the standard care. […] Patients receiving tocilizumab showed significantly greater survival rate as compared to control patients (hazard ratio for death, 0.035; 95% confidence interval [CI], 0.004 to 0.347; p = 0.004), adjusting for baseline clinical characteristics. […] Two out of 62 patients of the tocilizumab group and 11 out of 23 in the control group died. 92% and 42.1% of the discharged patients in the tocilizumab and control group respectively, recovered. […] The respiratory function resulted improved in 64.8% of the observations in tocilizumab patients who were still hospitalized, whereas 100% of controls worsened and needed mechanical ventilation. […] Tocilizumab results to have a positive impact if used early during Covid-19 pneumonia with severe respiratory syndrome in terms of increased survival and favorable clinical course.
32406985 Herein, we report a case of successful treatment of SARS-CoV-2 induced inflammatory syndrome by utilization of the interleukin-6 receptor antagonist (IL-6Ra) tocilizumab.
32410234 Intravenous tocilizumab, an antirheumatic drug, seems to be promising in counteracting cytokine storm caused by SARS-CoV-2 infection with associated clinical improvements. […] We report herein a case series of patients with COVID-19 pneumonia who were treated with tocilizumab administrated, for the first time, subcutaneously with good clinical and radiological outcomes.
32410772 Thus, anti-proinflammatory cytokine drugs like Anakinra and Tocilizumab are undergoing multiple trials and some results are encouraging.
32412509 Monoclonal antibodies targeting different pro-inflammatory cytokines, such as tocilizumab, an anti-interleukin 6 agent, are being tried with encouraging results.
32413736 Tocilizumab, a monoclonal antibody against IL6, could confer clinical benefit in patients with high IL6 levels.
32416330 Case report RESULTS: We report a fingolimod-treated MS patient who developed severe COVID-19 but recovered after treatment with tocilizumab. […] This report suggests that a brief course of tocilizumab for the treatment of severe COVID-19 may be effective while not aggravating pre-existing MS.
32419524 In addition, tocilizumab might be considered as the supplementary treatment for COVID-19 patients with cytokine release syndrome.
32421092 Since the outbreak of COVID-19 many studies have been published showing possible therapies, here the author discusses the end of stage disease related drugs, like Tocilizumab which is currently being used in ARDS patients.
32425246 The only FDA approved drug to treat COVID-19 is remdesivir, and other off-label medications used include chloroquine and hydroxychloroquine, tocilizumab, lopinavir/ritonavir, favipiravir, convalescent plasma therapy, azithromycin, vitamin C, corticosteroids, interferon and colchicine.
32425662 Patients were divided in two groups: 42 severe cases (TOCI) with adverse prognostic features including raised CRP and IL-6 levels, who underwent anti-cytokine treatments, mostly tocilizumab, and 69 standard of care patients (SOC).
32426957 The paper reviews aspects of COVID-19 that pertain to rheumatology, including symptoms and signs akin to those observed in rheumatic disorders, risk of infection or severe course of the disease in patients with a pre-existing rheumatic disease and those receiving antirheumatic or immunosuppressive medication as well as potential applications of antirheumatic or anticytokine therapeutic strategies that are already applied in rheumatology (including chloroquine, hydroxychloroquine, tocilizumab, baricitinib, and others) for patients with COVID-19.
32433778 Several drugs with anti-inflammatory properties (tocilizumab, siltuximab, sarilumab, anakinra, among others) have been suggested as adjuncts to supportive care in the management of COVID-19, and several clinical trials are underway (NCT04315298, NCT04317092, NCT04306705).
32434788 A monoclonal anti-IL-6 receptor antibody, tocilizumab has been administered in a number of cases in China and Italy.
32436445 The use of chloroquine or hydroxychloroquine (HCQ), remdesivir, and tocilizumab are some of the other promising potential therapies; however, they are yet to be tested in randomized clinical trials (RCTs).
32436867 Patients are being treated with protease drugs are inhibitors, remdesivir, chloroquine, angiotensin-converting enzyme 2 inhibitors, ivermectin, sarilumab and tocilizumab, though none of these is Food and Drug Administration approved and are undergoing trials.
32436994 Inhibition of the IL-6 pathway with tocilizumab has been employed successfully in some of these patients but the data is mostly consistent of case reports and series. […] We performed a systematic search of PubMed, Embase, and Medline from 22nd April 2020 and again on 27th April 2020 using the following search terms alone or in combination: “COVID-19”, “coronavirus”, “SARS-CoV-2”, “COVID”, “anti-interleukin 6 receptor antibodies”, “anti-IL-6”, “tocilizumab”, “sarilumab”, “siltuximab”. […] IL-6 level was significantly higher after the initiation of tocilizumab with median (IQR) of 376.6 (148-900.6) pg/mL compared to the baseline of 71.1 (31.9-122.8) pg/mL (p=0.002). […] In COVID-19 patients treated with tocilizumab, IL-6 levels are significantly elevated which are supportive of cytokine storm. […] Following initiation of tocilizumab, there is elevation in the IL-6 levels and CRP levels dramatically decrease suggesting an improvement in this hyper-inflammatory state. […] However, to our knowledge, there is no individual patient data systematic review performed to summarize baseline characteristics and clinical outcomes of COVID 19 patients who received tocilizumab.
32439306 In the absence of a vaccine, the management of COVID-19 included antivirals, high-flow oxygen, mechanical ventilation, corticosteroids, hydroxychloroquine, tocilizumab, interferons, intravenous immunoglobulin, and convalescent plasma infusions.
32441332 Forty-one patients (68.6%) required hospital admission (18 due to disease worsening and 23 for delivery) of whom 21 patients (35%) underwent pharmacological treatment, including hydroxychloroquine, antivirals, antibiotics and tocilizumab.
32441764 PARPi’s may potentiate the effectiveness of Tocilizumab, Anakinra, Sarilumab, Adalimumab, Canakinumab or Siltuximab therapy.
32441805 Therefore, an add-on therapy with drugs able to reduce inflammation, edema, and cell activation has been proposed as well as a treatment with interferon, corticosteroids or monoclonal antibodies (eg, tocilizumab).
32445484 Several drugs are being repurposed into clinical trials in COVID-19 patients, ranging from drugs already well established in other diseases, such as chloroquine/hydroxychloroquine, lopinavir+ ritonavir, azithromycin and tocilizumab/sarilumab, to those such as remdesivir still in development for their initial indication (1).
32447102 Tocilizumab (TCZ) is used for treating moderate-to-severe Covid-19 pneumonia by targeting interleukin-6 receptors (IL-6Rs) and reducing cytokine release.
32448770 Tocilizumab, a humanized monoclonal antibody, targets IL-6 receptors blocking downstream pro-inflammatory effects of IL-6. […] In this open-label prospective study we describe clinical characteristics and outcome of 51 patients hospitalized with confirmed and severe COVID-19 pneumonia treated with tocilizumab intravenously. […] From baseline to day 7 after tocilizumab we observed a dramatic drop of body temperature and CRP value with a significant increase in lymphocyte count (p<0.001). […] Over a median follow-up time of 34 days from tocilizumab, 34 patients (67%) showed an improvement in their clinical severity class; 31 were discharged; 17 (33%) showed a worsening of their clinical status, of these 14 died (27%). […] Tocilizumab exerts a rapidly beneficial effect on fever and inflammatory markers, although no significant impact on the clinical outcome can be inferred by our results.
32449235 We report a case of the successful recovery from severe COVID-19 of a kidney-transplanted patient treated with hydroxychloroquine, lopinavir/ritonavir, steroid and tocilizumab.
32459790 Tocilizumab was applied in two intubated children.
32461326 Tocilizumab was administered to 4 patients and hydroxychloroquine to 1 patient.
32462717 Two humanized monoclonal antibodies are in clinical trial following IL6R antagonist therapies namely tocilizumab and sarilumab.
32463803 Off-label treatment with tocilizumab restored the cytotoxic potential of NK cells.
32470751 Thus, anti-proinflammatory cytokine drugs like Anakinra and Tocilizumab are undergoing multiple trials and some results are encouraging.
32471001 A subset of patients was treated with anti-retroviral and tocilizumab.
32476080 The following variables were extracted for this study: age, gender, temperature, and saturation of oxygen on admission, treatment with heparin, hydroxychloroquine, azithromycin, steroids, tocilizumab, a combination of lopinavir with ritonavir, and oseltamivir, together with data on mortality.
32476261 Tocilizumab is an IL-6 receptor antagonist with a record of use for a variety of rheumatologic conditions and cytokine release syndrome due to CAR T-cell therapy but experience in solid organ and composite tissue transplant recipients (SOT/CTTRs) with SARS-CoV-2-related ARDS has not been previously reported in detail. […] We present the clinical course of five SOT/CTTRs with SARS-CoV-2-related ARDS that received tocilizumab with favorable short-term outcomes in four. […] Four bacterial infections occurred within two weeks of tocilizumab administration. […] We discuss safety concerns and the need for randomized comparative trials to delineate tocilizumab’s clinical utility in this population.
32478465 Tocilizumab (TCZ; interleukine-6 receptor antagonist) has been proposed to treat severe forms of Coronavirus disease-19 (COVID-19) because interleukine-6 plays an important role in COVID-19-induced cytokine storm.
32482373 Tocilizumab, a humanized monoclonal antibody, is designed to bind both mIL-6R (membrane bound receptor for IL-6) and sIL-6R (soluble receptor for IL-6) and inhibit the JAK-STAT or MAPK/NF-κB-IL-6 signaling pathway. […] However, we need to understand that how tocilizumab is bound with mIL-6R or sIL-6R. […] Similarly, we also need to understand more about the real molecular mechanism of activity of tocilizumab.
32482597 Tocilizumab (TCZ), a humanized monoclonal antibody targeting the interleukin-6 (IL-6) receptor, has been proposed for the treatment of COVID-19 patients; however, limited data are available on the safety and efficacy. […] Mortality was 15% in the tocilizumab group and 33% in standard treatment group (p = 0.15). […] At day 28, clinical improvement and mortality were not statistically different between tocilizumab and standard treatment patients in our cohort. […] Bacterial or fungal infections were recorded in 13% of tocilizumab patients and in 12% of standard treatment patients.
32484930 To recognize the period of exaggerated cytokine response in patients with Coronavirus disease 2019 (COVID-19) pneumonia, and to describe the clinical outcomes of using tocilizumab as a treatment option. […] A dramatic laboratory and clinical improvement was observed in 83% (10/12) of patients after tocilizumab. […] While arterial oxygen saturations (87.58±3.12%) dropped in room air in the pre-tocilizumab period, post-tocilizumab they normalized in all patients (94.42±1%). […] None of them had fever after tocilizumab treatment and the levels of c-reactive protein (13.08±12.89) were almost within normal limits. […] Eosinophil values were quite low at the time of diagnosis (10±17.06), but increased significantly post-tocilizumab (155.33±192.69). […] Based on our experience with twelve adult COVID-19 pneumonia patients, we can say that tocilizumab, an IL-6 inhibitor, is more beneficial in preventing the damage caused by excessive cytokine response in the body if administered at the right time and provides clinical and radiological recovery.
32493441 The experimental arms consist of Anakinra alone (anti-IL-1 binding the IL-1 receptor), Siltuximab alone (anti-IL-6 chimeric antibody), a combination of Siltuximab and Anakinra, Tocilizumab alone (humanised anti-IL-6 receptor antibody) or a combination of Anakinra with Tocilizumab in addition to standard care. […] Siltuximab (11mg/kg) or Tocilizumab (8mg/kg, with a maximum dose of 800mg) are administered as a single intravenous injection immediately after randomization. […] A 2x2 factorial design was selected with a 2:1 randomization regarding the IL-1 blockade (Anakinra) and a 1:2 randomization regarding the IL-6 blockade (Siltuximab and Tocilizumab). […] A total of 342 participants will be enrolled: 76 patients will receive usual care, 76 patients will receive Siltuximab alone, 76 patients will receive Tocilizumab alone, 38 will receive Anakinra alone, 38 patients will receive Anakinra and Siltuximab and 38 patients will receive Anakinra and Tocilizumab.
32493514 Objective of this study is to evaluate the efficacy and safety of a single dose treatment with Tocilizumab in patients with severe COVID-19. […] We hypothesize that Tocilizumab slows down the progression of SARS-CoV-2 induced pneumonia and inflammation. […] Desirable outcomes would be that tocilizumab reduces the number of days that patients are dependent on mechanical ventilation and reduces the invasiveness of breathing assistance. […] Next to these efficacy parameters, safety of a therapy with Tocilizumab in COVID-19 patients has to be monitored closely, since immunosuppression could lead to an increased rate of bacterial infections, which could negatively influence the patient’s outcome. […] Known allergic reactions to tocilizumab or its ingredients12. […] Intervention arm: Application of 8mg/kg body weight (BW) Tocilizumab i.v. once immediately after randomisation (12 mg/kg for patients with <30kg BW; total dose should not exceed 800 mg) AND conventional treatment.
32495916 Tocilizumab is a blocker of interleukin-6 receptor, which is likely to become an effective drug for patients with severe COVID-19. […] Here, we reported a case in which tocilizumab was effective for a critical COVID-19 patient.
32497796 Specific coagulation and inflammatory markers (D-dimer, ferritin, and C-reactive protein), along with the clinical picture, triggered the trial of recombinant tissue plasminogen activator (rt-PA) and tocilizumab. […] No major complications associated with rt-PA or tocilizumab occurred.
32499314 Blockers of this cytokine (tocilizumab, sarilumab and siltuximab) are being studied as a strategy for treating the disease.
32499832 Corticosteroids and tocilizumab seem to guarantee positive results in selected patients so far, although the timing of starting therapy and the most appropriate therapeutic schemes remain to be clarified.
32500936 Few reports described the outcome of kidney transplanted patients (KTs) affected by COVID-19 treated with interleukin-6 receptor inhibitor Tocilizumab (TCZ). […] Four out of six patients died, at an average time of 9.75±2.4 days after tocilizumab administration, 3/6 due to a coexistent septic shock.
32503817 Finally, a very promising therapeutic drug, tocilizumab, is discussed; it is currently used to treat patients presenting COVID-19 pneumonia.
32512263 Two tocilizumab users had a mild infection. […] Patients on hydroxychloroquine, TNFα antagonists or tocilizumab may have a mild viral illness.
32515499 It is unknown which patients could require higher doses of tocilizumab to get out of the cytokine storm. […] All the patients underwent tocilizumab 8 mg/kg intravenously and were tested for serum IL-6 24-48 hours before and 12-48 hours after tocilizumab infusion. […] IL-6 was not different at baseline (p=0.41), while 24-48h post-tocilizumab IL-6 serum levels were significantly higher in non-survivors than in survivors [2398.5 (430.5-9372) pg/mL vs 290.5 (58.5-1305.5) pg/mL, p=0.022)]. […] Serum IL-6 post-tocilizumab showed a good predictive ability to discriminate survivors from non-survivors (AUC 0.815 95%CI 0.63-0.99, p=0.02). […] Repeated measurement of serum level of IL-6 early after tocilizumab may distinguish non-survivors from survivors and support the choice of deeper targeting IL-6 in COVID-19 pneumonia.
32516506 Multiple therapeutic strategies, including antibody therapies (such as Tocilizumab, Sarilumab, Siltuximab), therapeutic plasma exchange (TPE), and blood purification techniques for direct removal of cytokines, including filtration, dialysis (diffusion), and adsorption are available.
32523930 Tocilizumab (TCZ), an interleukin-6 (IL-6) inhibitor, may ameliorate the CRS associated with severe COVID-19 and thus improve clinical outcomes. […] Tocilizumab may have a role in treating severe COVID-19 patients with CRS.
32524645 We comment on hydroxychloroquine, chloroquine, lopinavir/ritonavir with zinc supplement, remdesivir, tocilizumab, ciclesonide, niclosamide and high-dose intravenous immunoglobulin (IVIG).
32526083 During the hospitalization, 86 patients developed de novo LFTs abnormality, which was associated with the use of tocilizumab, lopinavir/ritonavir and acetaminophen and not clearly associated with the composite endpoint.
32532461 Treatment is tocilizumab. […] We included 92 patients with CSS associated to COVID-19 who received GC, GC, and tocilizumab and only tocilizumab. […] The hazard ratio of the final variables with GC versus the group in which only tocilizumab was administered was lower as CGs were considered, with statistical significance for survival. […] The early use of GC pulses could control SLC, with a lower requirement to use tocilizumab and a decrease in events such as intubation and death.
32533671 This area has faced numerous challenges, including the shortage of frequent-use products (hydroalcoholic solutions, lopinavir/ritonavir suspension), the use of new preparations for SARS-CoV-2 (tocilizumab, remdesivir), or requests from overwhelmed wards unable to assume the safe preparation of a high volume of medications (intravenous solutions). […] Como todo el sector sanitario, la farmacotecnia hospitalaria ha sufrido el impacto de la pandemia de la COVID-19, enfrentándose a la necesidad de cubrir el desabastecimiento de productos de uso frecuente (soluciones hidroalcohólicas, lopinavir/ritonavir suspensión), a nuevas preparaciones surgidas de las nuevas necesidades provocadas por el SARS-CoV-2 (tocilizumab, remdesivir), o a peticiones de plantas desbordadas por la carga asistencial, incapaces de asumir con un mínimo de seguridad la preparación de numerosos medicamentos (mezclas intravenosas).
32535732 Considering the proven role of cytokine dysregulation in causing this hyperinflammation in the lungs with IL-6 being a key driver, particularly in seriously ill COVID-19 patients, it is crucial to further explore selective cytokine blockade with drugs like the IL-6 inhibitors tocilizumab, sarilumab, and siltuximab. […] Preliminary evidence has come for tocilizumab from some small studies, and interim analysis of a randomized controlled trial; the latter also being available for sarilumab.
32535894 In multivariable analysis, anti-inflammatory treatment was independently associated with the development of BSI (cause-specific hazard ratio [csHR] 1.07 with 95% CI 0.38-3.04 for tocilizumab, csHR 3.95 with 95% CI 1.20-13.03 for methylprednisolone, and csHR 10.69 with 95% CI 2.71-42.17 for methylprednisolone plus tocilizumab, with no anti-inflammatory treatment as the reference group; overall p for the dummy variable = 0.003).
32539627 In particular, the anti-IL-6-receptor monoclonal antibody tocilizumab is emerging as one of the most promising pharmacologic treatments. The reviews of this paper are available via the supplemental material section.
32541085 Case reports and result of small case series suggest efficacy of an IL6 inhibitor monoclonal antibody (tocilizumab) in treating CRS.
32544802 The main drug interactions were found with tocilizumab, ruxolitinib and colchicine.
32546029 Tocilizumab and lenzilumab are recombinant monoclonal antibodies against IL-6 and granulocyte macrophage colony-stimulating factor, respectively, and have been proposed as a potential treatment for acute, hypoxic respiratory failure associated with COVID-19. Results & methodology: We present the case of a 68-year-old man with COVID-19 who was initially treated with hydroxychloroquine and lenzilumab, but continued to develop hypoxemia, requiring an increase in respiratory support with an associated rise in serum inflammatory markers. […] He was subsequently treated with tocilizumab with marked clinical improvement and a decrease in acute phase reactants within 48 h. Discussion & conclusion: This case demonstrates the effective use of tocilizumab in the treatment of COVID-19 and suggests the superiority of tocilizumab over lenzilumab in the management of this cytokine-mediated syndrome.
32553536 Tocilizumab, an interleukin-6 receptor antagonist (IL-6Ra), can treat cytokine release syndrome (CRS) with observed improvements in COVID-19 case series. […] Can tocilizumab benefit hospitalized COVID-19 patients? […] Patients were treated with tocilizumab using an algorithm that targeted CRS. […] For tocilizumab-treated patients, a pre/post analyses of clinical response, biomarkers and safety outcomes was assessed. […] Tocilizumab-treated patients (N=153, 64%) involved 90% of severe patients; 44% of non-severe patients received it for evolving CRS. […] Tocilizumab-treated patients with severe disease had higher admission hsCRP levels (120 vs 71mg/L; p<0.001), received tocilizumab sooner (2 vs 3 days; p<0.001), but survival was similar to non-severe patients (83% vs 91%; p=0.11). […] For tocilizumab-treated patients requiring MV, survival was 75% (95%CI=64%-89%). […] After tocilizumab, few adverse events occurred, oxygenation and inflammatory biomarkers (e.g., hsCRP, IL-6) improved; however, D-dimer and sIL2R levels increased significantly. […] A treatment algorithm that included tocilizumab to target CRS may influence mechanical ventilation and survival outcomes. […] In tocilizumab-treated patients, oxygenation and inflammatory biomarkers improve with higher than expected survival.
32553861 For treatment, intravenous immunoglobulin was used in 18 (54%), corticosteroids in 17 (51%), tocilizumab in 12 (36%), remdesivir in 7 (21%), vasopressors in 17 (51%), mechanical ventilation in 5 (15%), extracorporeal membrane oxygenation (ECMO) in 1 (3%), and intra-aortic balloon pump in 1 (3%).
32557214 It is important to critically analyze the available evidence concerning the use of the available anti-IL-6 (siltuximab) and anti-IL-6R (tocilizumab and sarilumab) agents in COVID-19 patients, in terms of both benefit and risk.
32557541 Tocilizumab is a potential recombinant monoclonal antibody against IL-6 and currently is under investigation for the management of ARDS in patients with COVID-19. […] Given these points, we reviewed the current evidence regarding the potential therapeutic role of tocilizumab and its important clinical issues in the treatment of ARDS related to COVID-19.
32561148 Clinically available and investigational immunomodulators, such as the interleukin 6 inhibitors tocilizumab and sarilumab and the anti-granulocyte-macrophage colony-stimulating factor lenzilumab, are being tested for their anticipated effect in counteracting the pro-inflammatory cytokine environment that characterizes severe and critical COVID-19.
32562070 Tocilizumab was applied and intended to target both COVID-19 and RA. […] However, disease of this patient aggravated after usage of tocilizumab. […] Thus, we suggest careful considerations before and close monitoring in the administration of tocilizumab in rheumatic patients with COVID-19. […] Besides tocilizumab, several disease-modifying antirheumatic drugs (DMARDs) can also be applied in the treatment of COVID-19.
32562561 Immunomodulatory therapy with tocilizumab was used in 2 patients.
32563584 Tocilizumab (anti-IL-6R) was in low supply in the hospital.
32564984 We classified patients as those who received only glucocorticoid (GC) pulses, or GC and tocilizumab pulses. […] All patients received GC pulses and in 2 cases simultaneously tocilizumab. […] The 2 patients who received tocilizumab died. […] Although it seems that the early use of GC pulses could control it, and the use of other treatments such as tocilizumab shouldo be, with the study design and its limitations, this conclusion cannot be stablished.
32568411 We read with great interest the research article written by Borku Uysal B et al which is in accordance with the so far accumulating knowledge that tocilizumab is an effective treatment for COVID-19 cytokine storm syndrome (CSS).
32568969 These therapies include immunomodulators (i.e. intravenous immunoglobulin, thymosin α-1, IL-6, tocilizumab, cyclosporine, thalidomide, fingolimod), Chinese medicines (i.e. glycyrrhizin, baicalin, Xuebijing), anti-vascular endothelial growth factors (bevacizumab), estrogen modulating drugs, statins and nutritional supplements (i.e. vitamin A, B, C, D, E and zinc).
32569363 The interleukin-6 inhibitor tocilizumab has the potential to improve outcomes in these patients by preventing the development of cytokine release storm. […] We conducted a retrospective, case-control, single-center study in patients with severe to critical COVID-19 disease treated with tocilizumab. […] A total of 193 patients were included in the study. 96 patients received tocilizumab, while 97 served as control group. […] More patients in the tocilizumab group reported fever, cough, and shortness of breath (83%, 80%, and 96% versus 73%, 69%, and 71%, respectively). […] When excluding intubated patients, there was statistically significant lower mortality in patients treated with tocilizumab (6 vs. […] Our study showed a non-statistically significant lower mortality in patients with severe to critical COVID-19 disease who received tocilizumab. […] When intubated patients were excluded, the use of tocilizumab was associated with lower mortality.
32569708 The inflammatory phase includes therapeutic options like Tocilizumab, Anakinra, Baricitinib, Eculizumab, Emapalumab and Heparin.
32570043 Patients were divided in two groups: 42 severe cases (TOCI) with adverse prognostic features including raised CRP and IL-6 levels, who underwent anti-cytokine treatments, mostly tocilizumab, and 69 standard of care patients (SOC).
32570240 One patient also received tocilizumab as a salvage treatment.
32571730 Several studies have proposed that anti-IL-6 receptor antibodies, such as tocilizumab, play an important role in the treatment of severe acute respiratory infection associated with SARS-CoV-2.
32573419 Beneficial effects of IL-6 blockade using a humanised anti-IL-6 receptor antibody, tocilizumab (TCZ) were previously reported in patients with COVID-19 related ARDS.
32573895 All KTRs received tocilizumab up to one dose. […] The critical evaluation of all cases suggests that the timing of the administration of tocilizumab, an interleukin-6 receptor antagonist, could be associated with a better efficacy when administered in concomitance to the drop of the oxygen saturation.
32573990 He was treated with tocilizumab with symptoms improvement, without a complete pulmonary function recovery. […] Skin rash, highly suggestive for COVID-19 cutaneous involvement, persisted for ten days despite tocilizumab administration.
32574287 Drugs against cytokine storm syndrome such as corticosteroids or tocilizumab are under investigation.
32574789 COVID-19 patients (n = 34) suffering from ARDS were treated with tocilizumab (TCZ).
32575124 Tocilizumab (anti-IL-6R) is FDA-approved for treatment of cytokine storm associated with chimeric antigen receptor T-cell therapy. […] Here we examined compassionate use of tocilizumab in patients with SARS-CoV-2 pneumonia. […] We report on a single-center study of tocilizumab in hospitalized patients with SARS-CoV-2 pneumonia. […] We examined clinical and laboratory parameters including oxygen and vasopressor requirements, cytokine profiles, and C-reactive protein (CRP) levels pre- and post-tocilizumab treatment. […] Twenty seven SARS-CoV-2 pneumonia patients received one 400 mg dose of tocilizumab. […] IL-6 was the predominant cytokine detected at tocilizumab treatment. […] Significant reductions in temperature and CRP were seen post-tocilizumab. […] Oxygen and vasopressor requirements diminished over the first week post-tocilizumab. […] Adverse events and serious adverse events were minimal, but two deaths (7.4%) occurred that were felt unrelated to tocilizumab. […] Compared to published reports on the morbidity and mortality associated with SARS-CoV-2, tocilizumab appears to offer benefits in reducing inflammation, oxygen requirements, vasopressor support, and mortality. […] The rationale for tocilizumab treatment is supported by detection of IL-6 in pathogenic levels in all patients. […] Additional doses of tocilizumab may be needed for those showing slow declines in CRP.
32581809 This is the case of chloroquine and tocilizumab which seem to limit virus replication and the severity of interstitial pneumonia, respectively.
32584416 6-8) Based on the success of IL-6 receptor blockade for chimeric antigen receptor T-cell therapy associated cytokine release syndrome (CAR T-cell CRS), similar strategies using tocilizumab are being investigated in COVID-19.
32584421 (3,4) There is emerging evidence for the use of an interleukin 6 (IL-6) inhibitor, tocilizumab (TCZ), for suppression of the inflammatory cytokine storm in this context.
32585765 Tocilizumab was administered after rising of serum IL-6 level.
32591970 Substantial clinical improvement was obtained following a management plan, which included tocilizumab, hydroxychloroquine, prednisolone and enoxaparin sodium.