“Pautas preliminares para el uso de tocilizumab en neumonía por COVID-19” “Pautas preliminares para el uso de tocilizumab en neumonía por COVID-19”
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Publicado:
sept 29, 2021
Palabras clave:
COVID-19, neumonía, tocilizumab, ventilación mecánica
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Resumen
Consideramos de importancia dar a conocer a la comunidad científica, las pautas preliminares para el uso de tocilizumab en neumonía por COVID-19, es un anticuerpo monoclonal recombinante dirigido contra el receptor alfa soluble y ligado a membrana de IL-6.
Si bien aún no se ha incorporado a las guías de tratamiento de la Organización Mundial de la Salud y no ha sido aprobado por el ANMAT en nuestro país para el tratamiento de COVID-19, debido a los beneficios adicionales al uso de dexametasona que podría tener tocilizumab, disminuyendo la mortalidad (particularmente en los casos más graves o con alto riesgo de progresión) y aliviando la tensión sobre los servicios de salud (al disminuir el tiempo de soporte orgánico y la estadía hospitalaria) consideramos oportuno realizar sugerencias preliminares para su uso en pacientes hospitalizados por COVID-19 en nuestro medio
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1.
cunto eleonora roxana. “Pautas preliminares para el uso de tocilizumab en neumonía por COVID-19”: “Pautas preliminares para el uso de tocilizumab en neumonía por COVID-19”. Rev Arg de Ter Int. [Internet]. 29 de septiembre de 2021 [citado 22 de noviembre de 2024];38. Disponible en: https://revista.sati.org.ar/index.php/MI/article/view/781
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10) BIBLIOGRAFIA
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2- Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8: 475-81. DOI: 10.1016/S2213-2600(20)30079-5
3- Cevik M, Tate M, Lloyd O, et al. SARS-CoV-2, SARSCoV- 1 and MERS-CoV viral load dynamics, duration of viral shedding and infectiousness — a living systematic review and meta-analysis. July 29, 2020 (https:// www .medrxiv .org/ content/10.1101/2020 .07.25.20162107v2).preprint.
4. Giamarellos-Bourboulis EJ, Netea MG, Rovina N, et al. Complex immune dysregulation in COVID-19 patients with severe respiratory failure. Cell Host Microbe 2020; 27(6): 992.e3-1000.e3.DOI: 10.1016 / j.chom.2020.04.009. Epub 2020 21 de abril
5. Aziz M, Fatima R, Assaly R. Elevated interleukin-6 and severe COVID-19: a metaanalysis. J Med Virol 2020; 92: 2283-5. DOI: 10.1002 / jmv.25948
6. Zhu J, Pang J, Ji P, et al. Elevated interleukin- 6 is associated with severity of COVID-19: a meta-analysis. J Med Virol 2020 May 29. DOI: 10.1002 / jmv.26085 (Epub ahead of print).
7. Pairo-Castineira E, Clohisey S, KlaricL, et al. Genetic mechanisms of critical illness in Covid-19. Nature 2020 December 11. DOIhttps://doi.org/10.1038/s41586-020-03065-y (Epub ahead of print).
8. Cellina M, Orsi M, Bombaci F, Sala M, et al. Favorable changes of CT findings in a patient with COVID-19 pneumonia after treatment with tocilizumab. Diagn Interv Imaging 2020; 101: 323-4. doi: 10.1016 / j.diii.2020.03.010
9. Michot J-M, Albiges L, Chaput N, et al. Tocilizumab, an anti-IL-6 receptor antibody, to treat COVID-19-related respiratory failure: a case report. Ann Oncol 2020; 31: 961-4. doi: 10.1016 / j.annonc.2020.03.300.
10. Antwi-Amoabeng D, Kanji Z, Ford B, et al. Clinical outcomes in COVID-19 patients treated with tocilizumab: an individual Patient data systematic review. J Med Virol 2020; 92: 2516-22. doi: 10.1002 / jmv.26038
11. Xu X, Han M, Li T, et al. Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl Acad Sci U S A 2020; 117: 10970-5. doi: 10.1073 / pnas.2005615117
12. Kaye A, Siegel R. The efficacy of IL-6 inhibitor tocilizumab in reducing severe COVID-19 mortality: a systematic review. September 3, 2020 (https://www.medrxiv.org/content/10.1101/2020.07.10.20150938v2).preprint.
13. Guaraldi G, Meschiari M, Cozzi-LepriA, et al. Tocilizumab in patients with severe COVID-19: a retrospective cohort study.Lancet Rheumatol 2020; 2(8): e474-e484. doi: 10.1016 / S2665-9913 (20) 30173-9
14. Somers EC, Eschenauer GA, Troost JP,et al. Tocilizumab for treatment of Mechanically ventilated patients with COVID-19. Clin Infect Dis 2020 July 11. DOI: 10.1093 / cid / ciaa954 (Epub ahead of print).
15. Sinha P, Mostaghim A, Catherine G. et al Early administration of Interleukin-6 inhibitors for patients with severe Covid-19 disease is associated with decreased intubation, reduced mortality, and increased discharge. https://doi.org/10.1016/j.ijid.2020.07.023
16. Ramiro S, Remy LM, Magro-Checa C et al. Historically controlled comparison of glucocorticoids with or without tocilizumab versus supportive care only in patients with COVID-19-associated Cytokine storm syndrome: results of the CHIC study. Ann Rheum Dis 2020;0:1–9. doi: 10.1136 / annrheumdis-2020-218479.
17. Price CC, Altice FL, Shyr Y et al. Tocilizumab treatment for Cytokine Release Syndrome in hospitalized COVID-19 patients: survival and clinical outcomes. https://doi.org/10.1016/j.chest.2020.06.006.
18. Stone JH, Frigault MJ, Serling-Boyd NJ, et al. Efficacy of tocilizumab in patients hospitalized withCOVID-19. N Engl J Med. 2020;383(24):2333-2344. DOI: 10.1056 / NEJMoa2028836.
19-Salvarani C, Dolci G, Massari M, et al. Effect of tocilizumab vs standard care on clinical worsening in patients hospitalized with COVID-19 pneumonia: a randomized clinical trial. JAMA Intern Med. 2021;181(1):24-31. doi: 10.1001 / jamainternmed.2020.6615.
20. Hermine O, Mariette X, Tharaux PL, et al. Effect of tocilizumab vs usual care in adults hospitalized with COVID-19 and moderate or severe pneumonia: a randomized clinical trial. JAMA Intern Med.2021;181(1):32-40. doi: 10.1001 / jamainternmed.2020.6820.
21. Gupta S, Wang W, Hayek SS, et al.Association between early treatment with tocilizumab and mortality among critically ill patients with COVID-19.JAMA Intern Med. 2021;181(1):41-51. doi: 10.1001 / jamainternmed.2020.6252
22. Rosas I, Bräu N, Waters M, et al. Tocilizumab in hospitalized patients with severe COVID-19 pneumonia. NEJM 2021. DOI: 10.1056/NEJMoa2028700
23. Veiga VC, Prats J, Farias DLC, et al. Effect of tocilizumab on clinical outcomes at 15 days in patients with severe or critical coronavirus disease 2019: randomised controlled trial.BMJ. 2021;372:n84. doi: https://doi.org/10.1136/bmj.n84
24. Salama C, Han J, Yau L, et al. Tocilizumab in patients hospitalized with COVID-19 pneumonia. N Engl J Med. 2021;384(1):20-30. DOI: 10.1056 / NEJMoa2030340
25. Gordon AC, Mouncey PR, al-Beidh KM et al (REMAP-CAP Investigators).
Interleukin-6 receptor antagonists in critically ill patients with COVID-19.
N Engl J Med. 2021. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33631065.
26. Horby PW, Pessoa-Amorim G, et al. (RECOVERY Collaborative Group). Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): preliminary results of a randomised, controlled, open-label, platformtrial. medRxiv. 2021;preprint. Available at: https://www.medrxiv.org/content/10.1101/2021.02.11.21249258v1
27- COVID-19 rapid evidence summary: Tocilizumab for COVID-19 .15 January 2021. www.nice.org.uk/guidance/es33
28- Interim Clinical Commissioning Policy: Tocilizumab for hospitalised patients with Covid-19 pneumonia (adults). Rapid Policy Statement. NHS. 8 January 2021
29- Interim Position Statement: Interleukin-6 inhibitors (tocilizumab or sarilumab) for patients admitted to ICU with COVID-19 pneumonia (adults). NHS. 22 February 2021
30- The COVID-19 Treatment Guidelines Panel¨s Statement on teh Use Of Tocilizumab for the Treatment of COVID-19. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. 05/03/2021.NIH.Available at: www.covid19treatmentguidelines.nih.gov
31- Wise J. Covid 19: arthritis drug tocilizumab improve survival in intensive care patients, shows study. BMJ 2021;372:n61. doi: https://doi.org/10.1136/bmj.n61
32-Wise J. Covid 19: arthritis drug tocilizumab reduces deaths in hospitalised patients, study shows. BMJ 2021;372:n433. doi: https://doi.org/10.1136/bmj.n433
33- Bhimraj A, Morgan RL, Shumaker AH et al. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19March 5, 2021 Version 4.1.0. Available at: www.idsociety.org/COVID19guidelines
34. Lier AJ, Tuan JL, Davis MW, et al. Case report: disseminated strongyloidiasis in a patient with COVID-19. Am J Trop Med Hyg. 2020.
Available at: http://www.ajtmh.org/docserver/fulltext/10.4269/ajtmh.20-0699/tpmd200699.pdf?expires=1598276702&id=id&accname=guest&checksum=D8AA596942F31C34007E0FE 065AF1F5F.
35. Marchese V, Crosato V, Gulletta M, et al. Strongyloides infection manifested during immunosuppressive therapy for SARS-CoV-2 pneumonia. Infection. 2020. Available at:
https://www.ncbi.nlm.nih.gov/pubmed/32910321.
36. Stauffer WM, Alpern JD, Walker PF. COVID-19 and dexamethasone: a potential strategy to avoid steroid related strongyloides hyperinfection. JAMA. 2020. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32761166
37-Chalmers JD, Crichton ML, Goeminne PC, et al. Management of
hospitalised adults with coronavirus disease-19 (COVID-19): A European Respiratory Society living guideline. Eur Respir J 2021; in press (https://doi.org/10.1183/13993003.00048-2021).
38-Tocilizumab for COVID-19. Evidence review. NICE (National Institute for Health and Care Excellence). 15 February 2021, last updated 24 February 2021.
39- Ghosn_L, Chaimani_A, Evrenoglou_T, et al. Interleukin-6 blocking agents for treating COVID-19: a living systematic review. Cochrane Database of Systematic Reviews 2021, Issue 3. Art. No.: CD013881.
DOI: 10.1002/14651858.CD013881.
40-Terapeutica para SARS-CoV2. 15 de Marzo de 2021. Sociedad Argentina de Infectologia. Disponible en www,sadi.org.ar
.
1- Guan W-J, Ni Z-Y, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708-20. DOI: 10.1056/NEJMoa2002032
2- Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8: 475-81. DOI: 10.1016/S2213-2600(20)30079-5
3- Cevik M, Tate M, Lloyd O, et al. SARS-CoV-2, SARSCoV- 1 and MERS-CoV viral load dynamics, duration of viral shedding and infectiousness — a living systematic review and meta-analysis. July 29, 2020 (https:// www .medrxiv .org/ content/10.1101/2020 .07.25.20162107v2).preprint.
4. Giamarellos-Bourboulis EJ, Netea MG, Rovina N, et al. Complex immune dysregulation in COVID-19 patients with severe respiratory failure. Cell Host Microbe 2020; 27(6): 992.e3-1000.e3.DOI: 10.1016 / j.chom.2020.04.009. Epub 2020 21 de abril
5. Aziz M, Fatima R, Assaly R. Elevated interleukin-6 and severe COVID-19: a metaanalysis. J Med Virol 2020; 92: 2283-5. DOI: 10.1002 / jmv.25948
6. Zhu J, Pang J, Ji P, et al. Elevated interleukin- 6 is associated with severity of COVID-19: a meta-analysis. J Med Virol 2020 May 29. DOI: 10.1002 / jmv.26085 (Epub ahead of print).
7. Pairo-Castineira E, Clohisey S, KlaricL, et al. Genetic mechanisms of critical illness in Covid-19. Nature 2020 December 11. DOIhttps://doi.org/10.1038/s41586-020-03065-y (Epub ahead of print).
8. Cellina M, Orsi M, Bombaci F, Sala M, et al. Favorable changes of CT findings in a patient with COVID-19 pneumonia after treatment with tocilizumab. Diagn Interv Imaging 2020; 101: 323-4. doi: 10.1016 / j.diii.2020.03.010
9. Michot J-M, Albiges L, Chaput N, et al. Tocilizumab, an anti-IL-6 receptor antibody, to treat COVID-19-related respiratory failure: a case report. Ann Oncol 2020; 31: 961-4. doi: 10.1016 / j.annonc.2020.03.300.
10. Antwi-Amoabeng D, Kanji Z, Ford B, et al. Clinical outcomes in COVID-19 patients treated with tocilizumab: an individual Patient data systematic review. J Med Virol 2020; 92: 2516-22. doi: 10.1002 / jmv.26038
11. Xu X, Han M, Li T, et al. Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl Acad Sci U S A 2020; 117: 10970-5. doi: 10.1073 / pnas.2005615117
12. Kaye A, Siegel R. The efficacy of IL-6 inhibitor tocilizumab in reducing severe COVID-19 mortality: a systematic review. September 3, 2020 (https://www.medrxiv.org/content/10.1101/2020.07.10.20150938v2).preprint.
13. Guaraldi G, Meschiari M, Cozzi-LepriA, et al. Tocilizumab in patients with severe COVID-19: a retrospective cohort study.Lancet Rheumatol 2020; 2(8): e474-e484. doi: 10.1016 / S2665-9913 (20) 30173-9
14. Somers EC, Eschenauer GA, Troost JP,et al. Tocilizumab for treatment of Mechanically ventilated patients with COVID-19. Clin Infect Dis 2020 July 11. DOI: 10.1093 / cid / ciaa954 (Epub ahead of print).
15. Sinha P, Mostaghim A, Catherine G. et al Early administration of Interleukin-6 inhibitors for patients with severe Covid-19 disease is associated with decreased intubation, reduced mortality, and increased discharge. https://doi.org/10.1016/j.ijid.2020.07.023
16. Ramiro S, Remy LM, Magro-Checa C et al. Historically controlled comparison of glucocorticoids with or without tocilizumab versus supportive care only in patients with COVID-19-associated Cytokine storm syndrome: results of the CHIC study. Ann Rheum Dis 2020;0:1–9. doi: 10.1136 / annrheumdis-2020-218479.
17. Price CC, Altice FL, Shyr Y et al. Tocilizumab treatment for Cytokine Release Syndrome in hospitalized COVID-19 patients: survival and clinical outcomes. https://doi.org/10.1016/j.chest.2020.06.006.
18. Stone JH, Frigault MJ, Serling-Boyd NJ, et al. Efficacy of tocilizumab in patients hospitalized withCOVID-19. N Engl J Med. 2020;383(24):2333-2344. DOI: 10.1056 / NEJMoa2028836.
19-Salvarani C, Dolci G, Massari M, et al. Effect of tocilizumab vs standard care on clinical worsening in patients hospitalized with COVID-19 pneumonia: a randomized clinical trial. JAMA Intern Med. 2021;181(1):24-31. doi: 10.1001 / jamainternmed.2020.6615.
20. Hermine O, Mariette X, Tharaux PL, et al. Effect of tocilizumab vs usual care in adults hospitalized with COVID-19 and moderate or severe pneumonia: a randomized clinical trial. JAMA Intern Med.2021;181(1):32-40. doi: 10.1001 / jamainternmed.2020.6820.
21. Gupta S, Wang W, Hayek SS, et al.Association between early treatment with tocilizumab and mortality among critically ill patients with COVID-19.JAMA Intern Med. 2021;181(1):41-51. doi: 10.1001 / jamainternmed.2020.6252
22. Rosas I, Bräu N, Waters M, et al. Tocilizumab in hospitalized patients with severe COVID-19 pneumonia. NEJM 2021. DOI: 10.1056/NEJMoa2028700
23. Veiga VC, Prats J, Farias DLC, et al. Effect of tocilizumab on clinical outcomes at 15 days in patients with severe or critical coronavirus disease 2019: randomised controlled trial.BMJ. 2021;372:n84. doi: https://doi.org/10.1136/bmj.n84
24. Salama C, Han J, Yau L, et al. Tocilizumab in patients hospitalized with COVID-19 pneumonia. N Engl J Med. 2021;384(1):20-30. DOI: 10.1056 / NEJMoa2030340
25. Gordon AC, Mouncey PR, al-Beidh KM et al (REMAP-CAP Investigators).
Interleukin-6 receptor antagonists in critically ill patients with COVID-19.
N Engl J Med. 2021. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33631065.
26. Horby PW, Pessoa-Amorim G, et al. (RECOVERY Collaborative Group). Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): preliminary results of a randomised, controlled, open-label, platformtrial. medRxiv. 2021;preprint. Available at: https://www.medrxiv.org/content/10.1101/2021.02.11.21249258v1
27- COVID-19 rapid evidence summary: Tocilizumab for COVID-19 .15 January 2021. www.nice.org.uk/guidance/es33
28- Interim Clinical Commissioning Policy: Tocilizumab for hospitalised patients with Covid-19 pneumonia (adults). Rapid Policy Statement. NHS. 8 January 2021
29- Interim Position Statement: Interleukin-6 inhibitors (tocilizumab or sarilumab) for patients admitted to ICU with COVID-19 pneumonia (adults). NHS. 22 February 2021
30- The COVID-19 Treatment Guidelines Panel¨s Statement on teh Use Of Tocilizumab for the Treatment of COVID-19. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. 05/03/2021.NIH.Available at: www.covid19treatmentguidelines.nih.gov
31- Wise J. Covid 19: arthritis drug tocilizumab improve survival in intensive care patients, shows study. BMJ 2021;372:n61. doi: https://doi.org/10.1136/bmj.n61
32-Wise J. Covid 19: arthritis drug tocilizumab reduces deaths in hospitalised patients, study shows. BMJ 2021;372:n433. doi: https://doi.org/10.1136/bmj.n433
33- Bhimraj A, Morgan RL, Shumaker AH et al. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19March 5, 2021 Version 4.1.0. Available at: www.idsociety.org/COVID19guidelines
34. Lier AJ, Tuan JL, Davis MW, et al. Case report: disseminated strongyloidiasis in a patient with COVID-19. Am J Trop Med Hyg. 2020.
Available at: http://www.ajtmh.org/docserver/fulltext/10.4269/ajtmh.20-0699/tpmd200699.pdf?expires=1598276702&id=id&accname=guest&checksum=D8AA596942F31C34007E0FE 065AF1F5F.
35. Marchese V, Crosato V, Gulletta M, et al. Strongyloides infection manifested during immunosuppressive therapy for SARS-CoV-2 pneumonia. Infection. 2020. Available at:
https://www.ncbi.nlm.nih.gov/pubmed/32910321.
36. Stauffer WM, Alpern JD, Walker PF. COVID-19 and dexamethasone: a potential strategy to avoid steroid related strongyloides hyperinfection. JAMA. 2020. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32761166
37-Chalmers JD, Crichton ML, Goeminne PC, et al. Management of
hospitalised adults with coronavirus disease-19 (COVID-19): A European Respiratory Society living guideline. Eur Respir J 2021; in press (https://doi.org/10.1183/13993003.00048-2021).
38-Tocilizumab for COVID-19. Evidence review. NICE (National Institute for Health and Care Excellence). 15 February 2021, last updated 24 February 2021.
39- Ghosn_L, Chaimani_A, Evrenoglou_T, et al. Interleukin-6 blocking agents for treating COVID-19: a living systematic review. Cochrane Database of Systematic Reviews 2021, Issue 3. Art. No.: CD013881.
DOI: 10.1002/14651858.CD013881.
40-Terapeutica para SARS-CoV2. 15 de Marzo de 2021. Sociedad Argentina de Infectologia. Disponible en www,sadi.org.ar
.