Administration Timing and Efficacy of Tocilizumab in Patients With COVID-19 and Elevated IL-6.
Administration Timing and Efficacy of Tocilizumab in Patients With COVID-19 and Elevated IL-6.
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托珠单抗在 COVID-19 和 IL-6 升高患者中的给药时机和疗效
DOI：
10.3389/fmolb.2021.651662
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发表时间：
2021
影响因子：
5
通讯作者：
Zhang W
中科院分区：
文献类型：
--
作者：
Li P;Lu Z;Li Q;Wang Z;Guo Y;Cai C;Wang S;Liu P;Su X;Huang Y;Dong Y;Qiu W;Ling Y;Yarmus L;Luo F;Zeng L;Bai C;Zhang W
托珠单抗（TCZ）是一种白细胞介素-6受体抗体，以前曾用于治疗2019冠状病毒病（COVID-19）患者，但缺乏关于TCZ给药时机的数据。目的本研究旨在评估TCZ治疗COVID-19患者的时机和疗效。方法经病理证实的COVID-19患者，白细胞介素-6（IL-6）水平升高（>10 pg/ml），静脉给予TCZ同情使用。回顾性分析临床特征、实验室检查和应用TCZ前后的胸部影像学检查。结果58例符合纳入标准但不符合排除标准的患者被纳入研究。在这58名患者中，39名患者接受TCZ治疗，19名拒绝TCZ治疗的患者用作对照组。在TCZ治疗组中，6名患者（15.4%）处于轻度状态，16名（41.0%）处于重度状态，17名（43.6%）处于危重状态。经TCZ治疗后，27例（69.2%）病情好转，12例（30.8%）死亡。与改善组相比，死亡组患者的IL-6（P = 0.0191）和降钙素原（PCT）（P = 0.0003）基线水平较高，淋巴细胞百分比（LYM）较低（P = 0.0059）。接受TCZ治疗的患者预后优于未接受TCZ治疗的患者（P = 0.0273）。此外，TCZ治疗组中基线IL-6水平≥100 pg/ml的患者的临床结局比IL-6水平<100 pg/ml的患者差（P = 0.0051）。结论在细胞因子风暴早期（IL-6 < 100 pg/ml）给予TCZ可通过阻断IL-6信号通路有效改善COVID-19患者的临床预后。
Background Tocilizumab (TCZ), an interleukin-6 receptor antibody, has previously been used for treating patients with the coronavirus disease 2019 (COVID-19), but there is a lack of data regarding the administration timing of TCZ. Objectives This study aimed to evaluate the timing and efficacy of TCZ in the treatment of patients with COVID-19. Methods Laboratory-confirmed patients with COVID-19 with an elevated interleukin-6 (IL-6) level (>10 pg/ml) were offered TCZ intravenously for compassionate use. Clinical characteristics, laboratory tests, and chest imaging before and after the administration of TCZ were retrospectively analyzed. Results A total of 58 consecutive patients who met the inclusion criteria and with no compliance to the exclusion criteria were included. Of these 58 patients, 39 patients received TCZ treatment, and 19 patients who declined TCZ treatment were used as the control cohort. In the TCZ-treatment group, 6 patients (15.4%) were in mild condition, 16 (41.0%) were in severe condition, and 17 (43.6%) were in critical condition. After TCZ treatment, the condition of 27 patients (69.2%) improved and 12 (30.8%) died. Compared with the improvement group, patients in the death group had higher baseline levels of IL-6 (P = 0.0191) and procalcitonin (PCT) (P = 0.0003) and lower lymphocyte percentage (LYM) (P = 0.0059). Patients receiving TCZ treatment had better prognoses than those without TCZ treatment (P = 0.0273). Furthermore, patients with a baseline IL-6 level of ≥100 pg/ml in the TCZ-treatment group had poorer clinical outcomes than those with an IL-6 level of <100 pg/ml (P = 0.0051). Conclusion The administration of TCZ in an early stage of cytokine storm (IL-6 level < 100 pg/ml) may effectively improve the clinical prognosis of patients with COVID-19 by blocking the IL-6 signal pathway.
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DOI：
10.1016/s0140-6736(03)13967-0
发表时间：
2003-07-26
期刊：
Lancet (London, England)
影响因子：
--
作者：
Kuiken T;Fouchier RA;Schutten M;Rimmelzwaan GF;van Amerongen G;van Riel D;Laman JD;de Jong T;van Doornum G;Lim W;Ling AE;Chan PK;Tam JS;Zambon MC;Gopal R;Drosten C;van der Werf S;Escriou N;Manuguerra JC;Stöhr K;Peiris JS;Osterhaus AD
通讯作者：
Osterhaus AD
DOI：
10.3760/cma.j.issn.0254-6450.2020.02.002
发表时间：
2020-02-10
影响因子：
--
作者：
通讯作者：
--
DOI：
10.3760/cma.j.issn.1001-0939.2020.0005
发表时间：
2020-02-06
期刊：
Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
影响因子：
--
作者：
Chen, L;Liu, H G;Wei, S
通讯作者：
Wei, S
影响因子：
5.4
作者：
Cheung, CY;Poon, LLM;Peiris, JSM
通讯作者：
Peiris, JSM
影响因子：
9.6
作者：
Price CC;Altice FL;Shyr Y;Koff A;Pischel L;Goshua G;Azar MM;Mcmanus D;Chen SC;Gleeson SE;Britto CJ;Azmy V;Kaman K;Gaston DC;Davis M;Burrello T;Harris Z;Villanueva MS;Aoun-Barakat L;Kang I;Seropian S;Chupp G;Bucala R;Kaminski N;Lee AI;LoRusso PM;Topal JE;Dela Cruz C;Malinis M
通讯作者：
Malinis M