Real World Long-term Assessment of The Efficacy of Tocilizumab in Patients with COVID-19: Results From A Large De-identified Multicenter Electronic Health Record Dataset in the United States.
Real World Long-term Assessment of The Efficacy of Tocilizumab in Patients with COVID-19: Results From A Large De-identified Multicenter Electronic Health Record Dataset in the United States.
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DOI：
10.1016/j.ijid.2021.09.067
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Zhi D
中科院分区：
文献类型：
--
作者：
Nigo M;Rasmy L;May SB;Rao A;Karimaghaei S;Kannadath BS;De la Hoz A;Arias CA;Li L;Zhi D
研究显示，托珠单抗（TCZ）对COVID-19患者的疗效存在相互矛盾的结果，临床状态存在许多混杂因素，观察持续时间有限。在这里，我们评估了TCZ在COVID-19患者中的实际长期疗效。我们使用美国大型多中心COVID-19数据库（Cerner真实世界数据;于2020年9月更新）对住院的COVID-19成人患者进行了一项回顾性研究。TCZ组定义为至少接受一剂药物的患者。匹配权重（MW）和倾向评分加权法用于平衡混杂因素。共识别出20，399名患者。TCZ组和对照组分别为1，510例和18，899例。MW调整后，TCZ组与对照组相比，全因死亡率无统计学显著差异（风险比[HR]：0.76，p=0.06）。生存曲线表明短期观察的趋势更好，来自需要氧气面罩、BIPAP或CPAP的患者亚组。我们观察到TCZ的暂时（早期）获益，特别是在非侵入性高流量辅助供氧的患者中。然而，随着观察时间的延长，受益效果逐渐消失。TCZ的长期获益和风险应通过随访研究进行仔细评估。
Studies have shown conflicting results on the efficacy of tocilizumab (TCZ) for patients with COVID-19, with many confounders of clinical status and limited duration of the observation. Here, we evaluate the real-world long-term efficacy of TCZ in COVID-19 patients. We conducted a retrospective study of hospitalized adult patients with COVID-19 using a large US-based multicenter COVID-19 database (Cerner Real-World Data; updated in September, 2020). The TCZ group was defined as patients who received at least one dose of the drug. Matching weight (MW) and a propensity score weighting method were used to balance confounding factors. A total of 20,399 patients were identified. 1,510 and 18,899 were in the TCZ and control groups, respectively. After MW adjustment, no statistically significant differences in all-cause mortality were found for the TCZ vs. control group (Hazard Ratio [HR]:0.76, p=0.06). Survival curves suggested a better trend in short-term observation, driven from a subgroup of patients requiring oxygen masks, BIPAP or CPAP. We observed a temporal (early) benefit of TCZ, especially in patients on non-invasive high-flow supplemental oxygen. However, the benefit effects faded with longer observation. The long-term benefits and risks of TCZ should be carefully evaluated with follow-up studies.
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影响因子：
8.8
作者：
Brown, Samuel M.;Duggal, Abhijit;Brower, Roy G.
通讯作者：
Brower, Roy G.
DOI：
10.1056/nejmoa2028700
发表时间：
2021-04-22
期刊：
The New England journal of medicine
影响因子：
--
作者：
Rosas IO;Bräu N;Waters M;Go RC;Hunter BD;Bhagani S;Skiest D;Aziz MS;Cooper N;Douglas IS;Savic S;Youngstein T;Del Sorbo L;Cubillo Gracian A;De La Zerda DJ;Ustianowski A;Bao M;Dimonaco S;Graham E;Matharu B;Spotswood H;Tsai L;Malhotra A
通讯作者：
Malhotra A
影响因子：
1.2
作者：
Li, Liang;Greene, Tom
通讯作者：
Greene, Tom
DOI：
10.1056/nejmoa2028836
发表时间：
2020-12-10
期刊：
The New England journal of medicine
影响因子：
--
作者：
Stone JH;Frigault MJ;Serling-Boyd NJ;Fernandes AD;Harvey L;Foulkes AS;Horick NK;Healy BC;Shah R;Bensaci AM;Woolley AE;Nikiforow S;Lin N;Sagar M;Schrager H;Huckins DS;Axelrod M;Pincus MD;Fleisher J;Sacks CA;Dougan M;North CM;Halvorsen YD;Thurber TK;Dagher Z;Scherer A;Wallwork RS;Kim AY;Schoenfeld S;Sen P;Neilan TG;Perugino CA;Unizony SH;Collier DS;Matza MA;Yinh JM;Bowman KA;Meyerowitz E;Zafar A;Drobni ZD;Bolster MB;Kohler M;D'Silva KM;Dau J;Lockwood MM;Cubbison C;Weber BN;Mansour MK;BACC Bay Tocilizumab Trial Investigators
通讯作者：
BACC Bay Tocilizumab Trial Investigators
影响因子：
4.2
作者：
Jacobs, Jeffrey P.;Stammers, Alfred H.;Slepian, Marvin J.
通讯作者：
Slepian, Marvin J.