Interleukin-6 receptor blockade in patients with COVID-19 : placing clinical trials into context

Copyright © 2021 Elsevier Ltd. All rights reserved..

The pleiotropic cytokine interleukin-6 (IL-6) has been implicated in the pathogenesis of COVID-19, but uncertainty remains about the potential benefits and harms of targeting IL-6 signalling in patients with the disease. The efficacy and safety of tocilizumab and sarilumab, which block the binding of IL-6 to its receptor, have been tested in adults with COVID-19-related acute respiratory illness in randomised trials, with important differences in trial design, characteristics of included patients, use of co-interventions, and outcome measurement scales. In this Series paper, we review the clinical and methodological heterogeneity of studies of IL-6 receptor antagonists, and consider how this heterogeneity might have influenced reported treatment effects. Timing from clinical presentation to treatment, severity of illness, and concomitant use of corticosteroids are among the factors that might have contributed to apparently inconsistent results. With an understanding of the sources of variability in these trials, available evidence could be applied to guide clinical decision making and to inform the enrichment of future studies.

Errataetall:

CommentIn: Lancet Respir Med. 2021 Jun;9(6):549-551. - PMID 34015326

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

The Lancet. Respiratory medicine - Vol. 9, No. 6 (2021), p. 655-664

Language:

English

Contributors:

Angriman, Federico
Ferreyro, Bruno L
Burry, Lisa
Fan, Eddy
Ferguson, Niall D
Husain, Shahid
Keshavjee, Shaf H
Lupia, Enrico
Munshi, Laveena
Renzi, Samuele
Ubaldo, Onion Gerald V
Rochwerg, Bram
Del Sorbo, Lorenzo

Urls:

Volltext

Keywords:

*COVID-19
*Clinical Trials as Topic
Antibodies, Monoclonal, Humanized
Humans
I031V2H011
Journal Article
NU90V55F8I
Patient Selection
Receptors, Interleukin-6
Research Support, Non-U.S. Gov't
Review
SARS-CoV-2
Sarilumab
Tocilizumab

Notes:

Date Completed 15.06.2021

Date Revised 15.06.2021

published: Print-Electronic

CommentIn: Lancet Respir Med. 2021 Jun;9(6):549-551. - PMID 34015326

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1016/S2213-2600(21)00139-9

PMID:

33930329

PPN (Catalogue-ID):

NLM325947023