About: Off-label use of tocilizumab for the treatment of SARS-CoV-2 pneumonia in Milan, Italy

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About: Off-label use of tocilizumab for the treatment of SARS-CoV-2 pneumonia in Milan, Italy Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Off-label use of tocilizumab for the treatment of SARS-CoV-2 pneumonia in Milan, Italy
Creator	Antinori, Spinello Corbellino, Mario Galli, Massimo Meroni, Luca Milazzo, Laura Sollima, Salvatore Mileto, Davide Colombo, Riccardo Cossu, Maria Merli, Stefania Oreni, Letizia Ridolfo, Anna Rizzardini, Giuliano Torre, Alessandro Vimercati, Stefania Galimberti, Laura Morena, Valentina Ballone, Elisabetta Bassoli, Cinzia Bestetti, Giovanna Bradanini, Lucia Foschi, Antonella Fossali, Tommaso Micheli, Valeria Minari, Caterina Negri, Cristina Niero, Fosca Perotti, Andrea
source	Elsevier; Medline; PMC
abstract	BACKGROUND: Tocilizumab, a humanized monoclonal antibody, targets IL-6 receptors blocking downstream pro-inflammatory effects of IL-6. In preliminary reports it was suggested to be beneficial in patients with severe COVID-19. METHODS: 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. All patients had elevated IL-6 plasma level (>40 pg/mL) and oxygen saturation <93% in ambient air. Clinical outcomes, oxygen support, laboratory data and adverse events were collected over a follow-up of 30 days. RESULTS: Forty-five patients (88%) were on high-flow oxygen supplementation, six of whom with invasive ventilation. 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%). The mortality rate was significantly associated with mechanical ventilation at baseline (83.3% vs 20% of patients on non-invasive oxygen support; p=0.0001). The most frequent side effects were an increase of hepatic enzymes (29%), thrombocytopenia (14%), and serious bacterial and fungal infections (27%). CONCLUSION: 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. Critically ill patients seem to have a high risk of serious infections with this drug.
has issue date	2020-05-21(xsd:dateTime)
bibo:doi	10.1016/j.ejim.2020.05.011
bibo:pmid	32448770
has license	no-cc
sha1sum (hex)	c440e8c26b3ac93afebd2c73d7d023abcdfa944d
schema:url	https://doi.org/10.1016/j.ejim.2020.05.011
resource representing a document's title	Off-label use of tocilizumab for the treatment of SARS-CoV-2 pneumonia in Milan, Italy
has PubMed Central identifier	PMC7241995
has PubMed identifier	32448770
schema:publication	Eur J Intern Med
resource representing a document's body	covid:c440e8c26b3ac93afebd2c73d7d023abcdfa944d#body_text
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