Background and importance Tocilizumab is an immunosuppressive agent which has demonstrated high efficacy in clinical trials for the treatment of coronavirus because its mechanism of action seems to inhibit the inflammatory cascade.
Aim and objectives To evaluate the efficacy and safety of tocilizumab during the global pandemic.
Material and methods A descriptive, observational, prospective study was conducted in patients receiving treatment with tocilizumab for SARS-CoV-2 during the pandemic in March 2020. Clinical data were collected: sex, age, medical history, diagnosis, hospitalisation days, patients admitted to the intensive care unit (ICU), patients who required mechanical ventilation, dose of tocilizumab, time from onset of symptoms to administration, concomitant drugs for SARS-CoV-2, final situation and adverse reactions. The data were obtained from the electronic medical records. All patients met the criteria established by the Spanish Agency of Medicines and Medical Devices (AEMPS): adequate biochemical parameters and absence of ongoing infections.
Results 130 patients were included in the study, 8 patients met the criteria of AEMPS, 75% were men and mean age was 70 (57–83) years. Background: 50% had arterial hypertension, 37.5% heart disease, 25% diabetes, 25% chronic obstructive pulmonary disease and 12.5% active neoplasia. The diagnosis was severe pneumonia in all cases. The average duration of hospitalisation was 29 (4–73) days. 50% of patients were admitted to the ICU and required mechanical ventilation. In 75%, the dose was 600 mg and the rest required 400 mg, all single doses. The average time from symptom onset to drug administration was 15 (10–30) days. Concomitant drug therapy for SARS-CoV-2: 100% hydroxychloroquine with azithromycin, 87.5% lopinavir/ritonavir, 37.5% methylprednisolone boluses, 25% oral methylprednisolone and 12.5% interferon-ß-1b. 87.5% of patients were discharged. No adverse reactions were reported.
Conclusion and relevance Treatment with tocilizumab could be considered a safe and effective option in patients with severe SARS-CoV-2 pneumonia. Further studies are necessary to confirm these preliminary results. Adjustment of the treatments to the criteria established by the regulatory agencies and the recording of health outcomes could contribute to more efficient therapies.
Conflict of interest No conflict of interest