IL-6 inhibitor agents reduce mortality in severe COVID-19

Objectives:
Preliminary studies showed that coronavirus disease 2019 (COVID-19) disrupts body immune system, including dysregulation of cytokine interleukin-6 (IL-6). IL-6 inhibitors agents have been used as treatment options for COVID-19, yet their benefit as therapeutic agents remains unclear. Therefore, this review article (meta-analysis) has been conducted.

What are the therapeutic effects of IL-6 inhibitor agents for the treatment of COVID-19?

Study design:
This review article included 18 studies (14 cohort, 3 case-control and 1 RCT)with a total of 3,303 patients, including 1,265 in the tocilizumab group, 28 in the sarilumab group, 30 in the siltuximab group and 1,980 in the control group.
All the subjects in intervention group also received standard treatment in addition with IL-6 inhibitor drugs.
Tocilizumab was the most commonly used in the studies (15 studies). A single dose of 400 mg or 8 mg/kg intravenous was the most commonly reported regimen of Tocilizumab.

Results and conclusions:
The investigators found meta-analysis of included studies revealed a significant reduction of 39% in mortality with tocilizumab and sarilumab [RR = 0.61, 95% CI = 0.49 to 0.76].

The investigators found no differences of IL-6 inhibitor agents compared to controls for hospital discharge [RR = 1.04, 95% CI = 0.86 to 1.24], length of stay [mean difference = -1.96 days, 95% CI = -4.24 to 0.33] or requirement for mechanical ventilation [RR = 0.68, 95% CI 0.32 to 1.45].

The investigators concluded that IL-6 inhibitor agents reduce the risk of mortality in COVID-19, especially in severe conditions. However, the appropriate dosage and drug administration remains unclear. Clinicians should consider the use of IL-6 inhibitor agents in well-established clinical trials to evaluating the benefit and risk of the drugs.

Original title:
Interleukin-6 (IL-6) inhibitors as therapeutic agents for coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis by Pinzon RT, Wijaya VO and Buana RB.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204364/

Additional information of El Mondo:
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