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dc.contributor.authorNational Centre for Pharmacoeconomics
dc.contributor.authorCOVID-19 Evidence Review Group for Medicines
dc.date.accessioned2020-08-05T10:15:53Z
dc.date.available2020-08-05T10:15:53Z
dc.date.issued2020-05-20
dc.identifier.urihttp://hdl.handle.net/10147/628004
dc.descriptionEmerging correlative evidence supports the view that hyperinflammation plays a key role in the pathogenesis of severe COVID-19. Elevated inflammatory markers including IL-6 levels have been described in patients with severe COVID-19. Recently, two meta-analyses examined the role of IL-6 in COVID-19 and concluded that IL-6 levels are significantly elevated in patients with COVID-19 and are associated with adverse clinical outcomes. Extrapolation of evidence from cytokine-driven hyperinflammatory related disorders suggests that patients who have severe COVID-19 with hyperinflammation could benefit from tocilizumab. Preliminary unpublished results from a multicentre, open-label, randomized, controlled trial (CORIMUNO-TOCI) in France which is evaluating tocilizumab for the treatment of moderate or severe COVID-19 pneumonia have reported a significantly lower proportion of patients requiring ventilator (non-invasive and mechanical) or death at day 14 in the tocilizumab arm however the study and efficacy and safety results have not been published or peer reviewed . Several small single-arm observational studies and retrospective case series/reports suggest that tocilizumab may be of benefit in patients with COVID-19 exhibiting signs of cytokine release syndrome (CRS), however there is still no definitive evidence supporting the routine use of tocilizumab in severe COVID-19. Furthermore, emerging evidence on the role of IL-6 suggests that the timing of administration the treatments for hyperinflammation is of critical importance. A preliminary report from Italy suggests that treatment with tocilizumab in patients with features of a cytokine storm may be more effective outside of the ICU setting in non-ventilated patients to prevent cytokine storm evolution. However, the timing of administration in relation to disease course remains uncertain.en_US
dc.language.isoenen_US
dc.publisherNational Centre for Pharmacoeconomicsen_US
dc.subjectCOVID-19en_US
dc.subjectCORONAVIRUSen_US
dc.subjectMEDICINESen_US
dc.subjectINFLAMMATORY DISEASESen_US
dc.titleRapid Evidence Review: Tocilizumab in the management of patients who have severe COVID-19 infection with suspected hyperinflammation. [v3.0]en_US
dc.typeReporten_US
refterms.dateFOA2020-08-05T10:15:55Z


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