TY - JOUR
T1 - Real World Long-term Assessment of The Efficacy of Tocilizumab in Patients with COVID-19
T2 - Results From A Large De-identified Multicenter Electronic Health Record Dataset in the United States
AU - Nigo, Masayuki
AU - Rasmy, Laila
AU - May, Sarah B.
AU - Rao, Aishwarya
AU - Karimaghaei, Sam
AU - Kannadath, Bijun Sai
AU - De la Hoz, Alejandro
AU - Arias, Cesar A.
AU - Li, Liang
AU - Zhi, Degui
N1 - Funding Information:
Sarah B May is supported by a training fellowship from the Gulf Coast Consortia, on the NLM Training Program in Biomedical Informatics and Data Science (T15LM007093). Laila Rasmy is supported by UTHealth Innovation for Cancer Prevention Research Training Program Pre-Doctoral Fellowship (CPRIT Grant RP160015).
Publisher Copyright:
© 2021 The Authors
PY - 2021/12
Y1 - 2021/12
N2 - Background: 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. Methods: 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. Results: 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. Conclusion: 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.
AB - Background: 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. Methods: 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. Results: 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. Conclusion: 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.
KW - COVID-19
KW - De-identified Database
KW - Tocilizumab
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U2 - 10.1016/j.ijid.2021.09.067
DO - 10.1016/j.ijid.2021.09.067
M3 - Article
C2 - 34597766
AN - SCOPUS:85118573747
SN - 1201-9712
VL - 113
SP - 148
EP - 154
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -