Tocilizumab No Better Than Standard Care for COVID-19 Patients

A new trial published in the journal BMJ suggests that tocilizumab is no better than standard care alone in improving clinical outcomes at 15 days. Tocilizumab blocks interleukin-6 and was thought to avert some of the more dire consequences of the disease. To test this theory researchers in Brazil conducted a randomized controlled trial involving 129 patients with an average age of 57 years with confirmed COVID-19.

Tocilizumab plus standard care and standard care alone were compared. Patients were receiving supplemental oxygen or mechanical ventilation and had abnormal levels of at least two chemicals linked to inflammation in their blood. Patients were randomly divided into two groups: 65 received tocilizumab plus standard care and 64 received standard care alone. By day 15, 18 (28%) patients in the tocilizumab group and 13 (20%) in the standard care group were receiving mechanical ventilation or died.

Death at 15 days occurred in 11 (17%) patients in the tocilizumab group compared with 2 (3%) in the standard care group. The increased number of deaths in the tocilizumab group raised safety concerns and the trial was stopped early. In both groups, deaths were attributed to covid-19 related acute respiratory failure or multiple organ dysfunction. It was concluded from the trial that the tocilizumab administration showed no added benefits.

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