Lancet Rheumatol:重症监护室的COVID-19患者采用Tocilizumab治疗对预后的影响

2020-08-17 MedSci原创 MedSci原创

Tocilizumab,是一种靶向白介素-6受体的单克隆抗体,有人认为它或可减轻重度COVID-19相关的细胞因子风暴综合征。本研究旨评估该药物对重症COVID-19患者预后的影响。

Tocilizumab,是一种靶向白介素-6受体的单克隆抗体,有人认为它或可减轻重度COVID-19相关的细胞因子风暴综合征。本研究旨在研究tocilizumab暴露和依赖ICU生命支持的COVID-19患者的住院相关死亡率的相关性。

该研究是一项回顾性的观察性队列研究,在美国的13家医院开展。纳入年满18岁的确诊COVID-19感染的需ICU支持的患者。前瞻性的从观察数据库中获得数据,比较接受tocilizumab与未接受tocilizumab的患者的预后。主要终点是住院相关死亡率。

2020年3月1日-4月22日,共764位COVID-19患者需ICU支持,其中210位(27%)接受了tocilizumab治疗。与是否接受tocilizumab治疗相关的因素有患者年龄、性别、肾功能和治疗地点。630位患者被纳入倾向评分匹配人群,其中210位接受了tocilizumab治疗,420位未接受tocilizumab治疗。630位患者中有358位(57%)死亡,其中包括102位(49%)接受tocilizumab治疗的患者和256位(61%)未接受tocilizumab治疗的患者。

总体上,从开始用药算起,接受tocilizumab治疗的患者和未接受tocilizumab治疗的患者的中位存活期分别是尚未达到和19天。在具有倾向匹配的主要多变量Cox回归分析中,接受tocilizumab治疗与医院相关死亡率降低之间存在关联。在需要器械通气支持和基础C反应蛋白≥15 mg/dL的亚组中,存在类似的相关性。

总结:在该观察性研究中,需要ICU支持的接受tocilizum治疗COVID-19患者的死亡率降低。正在进行中的随机对照试验的结果即将发布。

原始出处:

Noa Biran,et al. Tocilizumab among patients with COVID-19 in the intensive care unit: a multicentre observational study. The Lancet Rheumatology. August 14,2020.

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    2020-08-30 howi
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    2021-06-17 snf701207
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    2020-08-19 ms5000000741733160

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    2020-08-19 ms5000000741733160

    👍

    0

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    2020-08-19 bioon6
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    2020-08-17 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

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