Comparative evaluation of tocilizumab and itolizumab for treatment of severe COVID-19 in India : a retrospective cohort study
Background: Itolizumab downregulates the synthesis of proinflammatory cytokines and adhesion molecules by inhibiting CD6 leading to lower levels of interferon-γ, interleukin-6, and tumor necrotic factor-α and reduced T-cell infiltration at inflammatory sites. This study aims to compare the effects of tocilizumab and itolizumab in the management of severe coronavirus disease 2019 (COVID-19).
Methods: The study population was adults (>18 years) with severe COVID-19 pneumonia admitted to the intensive care unit receiving either tocilizumab or itolizumab during their stay. The primary outcome was clinical improvement (CI), defined as a two-point reduction on a seven-point ordinal scale in the status of the patient from initiating the drug or live discharge. The secondary outcomes were time until CI, improvement in PO2/FiO2 ratio, best PO2/FiO2 ratio, need for mechanical ventilation after administration of study drugs, time to discharge, and survival days.
Results: Of the 126 patients included in the study, 92 received tocilizumab and 34 received itolizumab. CI was seen in 46.7% and 61.7% of the patients in the tocilizumab and itolizumab groups, respectively and was not statistically significant (P=0.134). The PO2/FiO2 ratio was significantly better with itolizumab compared to tocilizumab (median [interquartile range]: 315 [200-380] vs. 250 [150-350], P=0.043). The incidence of serious adverse events due to the study drugs was significantly higher with itolizumab compared to tocilizumab (14.7% vs. 3.3%, P=0.032).
Conclusions: The CI with itolizumab is similar to tocilizumab. Better oxygenation can be achieved with itolizumab and it can be a substitute for tocilizumab in managing severe COVID-19.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Acute and critical care - (2024) vom: 01. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kumar, Abhyuday [VerfasserIn] |
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Date Revised 01.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.4266/acc.2023.00983 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370464192 |
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| 100 | 1 | |a Kumar, Abhyuday |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparative evaluation of tocilizumab and itolizumab for treatment of severe COVID-19 in India |b a retrospective cohort study |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 01.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Background: Itolizumab downregulates the synthesis of proinflammatory cytokines and adhesion molecules by inhibiting CD6 leading to lower levels of interferon-γ, interleukin-6, and tumor necrotic factor-α and reduced T-cell infiltration at inflammatory sites. This study aims to compare the effects of tocilizumab and itolizumab in the management of severe coronavirus disease 2019 (COVID-19) | ||
| 520 | |a Methods: The study population was adults (>18 years) with severe COVID-19 pneumonia admitted to the intensive care unit receiving either tocilizumab or itolizumab during their stay. The primary outcome was clinical improvement (CI), defined as a two-point reduction on a seven-point ordinal scale in the status of the patient from initiating the drug or live discharge. The secondary outcomes were time until CI, improvement in PO2/FiO2 ratio, best PO2/FiO2 ratio, need for mechanical ventilation after administration of study drugs, time to discharge, and survival days | ||
| 520 | |a Results: Of the 126 patients included in the study, 92 received tocilizumab and 34 received itolizumab. CI was seen in 46.7% and 61.7% of the patients in the tocilizumab and itolizumab groups, respectively and was not statistically significant (P=0.134). The PO2/FiO2 ratio was significantly better with itolizumab compared to tocilizumab (median [interquartile range]: 315 [200-380] vs. 250 [150-350], P=0.043). The incidence of serious adverse events due to the study drugs was significantly higher with itolizumab compared to tocilizumab (14.7% vs. 3.3%, P=0.032) | ||
| 520 | |a Conclusions: The CI with itolizumab is similar to tocilizumab. Better oxygenation can be achieved with itolizumab and it can be a substitute for tocilizumab in managing severe COVID-19 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a itolizumab | |
| 650 | 4 | |a management | |
| 650 | 4 | |a tocilizumab | |
| 700 | 1 | |a Kumar, Neeraj |e verfasserin |4 aut | |
| 700 | 1 | |a Pattanayak, Arunima |e verfasserin |4 aut | |
| 700 | 1 | |a Kumar, Ajeet |e verfasserin |4 aut | |
| 700 | 1 | |a Palavesam, Saravanan |e verfasserin |4 aut | |
| 700 | 1 | |a Manigowdanahundi Nagaraju, Pradhan |e verfasserin |4 aut | |
| 700 | 1 | |a Das, Rekha |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Acute and critical care |d 2018 |g (2024) vom: 01. Apr. |w (DE-627)NLM303272988 |x 2586-6060 |7 nnns |
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| 856 | 4 | 0 | |u http://dx.doi.org/10.4266/acc.2023.00983 |3 Volltext |
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