• Sao Paulo Med J · Jan 2022

    Meta Analysis

    Effectiveness and safety of tocilizumab for COVID-19: a systematic review and meta-analysis of randomized clinical trials.

    • Paula Ribeiro Lopes Almeida, Osmar Clayton Person, Maria Eduarda Dos Santos Puga, Maria Fernanda Giusti, PintoAna Carolina Pereira NunesACPN0000-0002-1505-877XPhD. Physiotherapist and Professor, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.Professor, Department of Biological and Health Sciences, Universid, Aline Pereira Rocha, and Álvaro Nagib Atallah.
    • MD. Otorhinolaryngologist and Postgraduate Student in Evidence-Based Health, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brasil.
    • Sao Paulo Med J. 2022 Jan 1; 141 (2): 168176168-176.

    BackgroundTocilizumab is an anti-human interleukin 6 receptor monoclonal antibody that has been used to treat coronavirus disease 2019 (COVID-19). However, there is no consensus on its efficacy for the treatment of COVID-19.ObjectiveTo evaluate the effectiveness and safety of tocilizumab for treating COVID-19.Design And SettingSystematic Review of randomized controlled trials (RCTs), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.MethodsWe searched MEDLINE via PubMed, EMBASE, CENTRAL, and IBECS for RCTs published up to March 2021. Two authors selected studies and assessed the risk of bias and the certainty of the evidence following Cochrane Recommendations.ResultsEight RCTs with 6,139 participants were included. We were not able to find differences between using tocilizumab compared to standard care on mortality in hospitalized patients with COVID-19 (risk ratio (RR) 0.97, 95% confidence interval (CI) 0.84 to 1.13; 8 trials; 5,950 participants; low-certainty evidence). However, hospitalized patients under tocilizumab plus standard care treatment seemed to present a significantly lower risk of needing mechanical ventilation (risk ratio = 0.78; 95% CI 0.64-0.94 moderate-certainty of evidence).ConclusionsTo date, the best evidence available shows no difference between using tocilizumab plus standard care compared to standard care alone for reducing mortality in patients with COVID-19. However, as a finding with a practical implication, the use of tocilizumab in association to standard care probably reduces the risk of progressing to mechanical ventilation in those patients.Registrationosf.io/qe4fs.

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