IDSA updates guidance to support use of tocilizumab for COVID-19
The Infectious Diseases Society of America has backed the use of tocilizumab for COVID-19.
In a change to its clinical guidelines, the IDSA now “suggests” the use of tocilizumab — a common rheumatoid arthritis medication — in addition to standard of care treatment such as steroids among patients hospitalized with progressive severe or critical COVID-19, rather than standard of care treatment alone.
Initial guidance by IDSA recommended against the routine use of tocilizumab in patients hospitalized with COVID-19.
The change followed the release of new results from the RECOVERY trial, which demonstrated that tocilizumab reduced deaths by an absolute difference of 4% among patients with COVID-19 who required oxygen and had evidence of inflammation.
To date, RECOVERY has assessed numerous potential treatments for COVID-19, including dexamethasone. Tocilizumab was added to the trial last April and assessed in more than 4,000 patients who were randomly assigned to receive either an IV infusion of tocilizumab or usual care.
The newly release data also suggested that, among patients with hypoxia and significant inflammation, tocilizumab in combination with a systemic corticosteroid like dexamethasone reduced mortality “by about one-third for patients requiring simple oxygen and nearly one-half for those requiring invasive mechanical ventilation,” according to a news release from the investigators.
Researchers reported that tocilizumab had other benefits, including increasing the probability of being alive at discharge within 28 days from 47% to 54% (RR = 1.23; 95% CI 1.12-1.34).
The IDSA began publishing living guidelines on the treatment of COVID-19 last April.
IDSA guidelines on the treatment and management of patients with COVID-19. https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management. Accessed February 23, 2021.