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
Artículo
en Inglés
|
LILACS-Express
| LILACS
| ID: biblio-1424661
Biblioteca responsable:
BR1.1
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:
Disponible
Colección:
Bases de datos internacionales
Contexto en salud:
ODS3 - Meta 3.3 Poner fin a las enfermedades desatendidas y detener enfermedades transmisibles
Problema de salud:
COVID-19
Base de datos:
LILACS
Tipo de estudio:
Ensayo clínico controlado
/
Guía de práctica clínica
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Revisión sistemática
Idioma:
Inglés
Revista:
São Paulo med. j
Asunto de la revista:
Cirurgia Geral
/
Cincia
/
Ginecologia
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Medicina
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Año:
2023
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Hospital Brasil, Rede DOR/BR
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Universidade Federal de São Paulo (UNIFESP)/BR
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Universidade Santo Amaro (UNISA)/BR