AI Article Synopsis
- The COVID-19 pandemic has highlighted the importance of effective treatments, leading to the investigation of Tocilizumab (TCZ), a monoclonal antibody, for managing severe cases of the disease.
- TCZ has shown potential in reducing mortality rates and adverse events when administered during the inflammatory phase of critical COVID-19 pneumonia, especially when used alongside other therapies like corticosteroids.
- Despite its benefits, clinicians must consider personalized medicine approaches, as there are gaps in data regarding TCZ's safety in pregnancy and its effectiveness in combination with other treatment strategies.
Article Abstract
Introduction: The COVID-19 pandemic caused by SARS-CoV-2 has been the major health concern in 2019 globally. Considering the severity and phase of the disease, various pharmacotherapy schedules were proposed. Here, we set out to provide close-up insights on the clinical utility of Tocilizumab (TCZ), a biologic monoclonal antibody in this regard.
Methods: In this comprehensive review, various databases, including Scopus, PubMed Central, Medline, Embase, Google Scholar, and preprint publishers (med/bioRxiv) were searched until January 30, 2024, according to the keywords and search criteria.
Results: Besides the pros and cons, compelling evidence purported the safety and efficacy of TCZ and indicated that it exhibits great potential to reduce short-term and all-cause (28-30-day) mortality. TCZ significantly drops the adverse events if administered in the right time course (in the inflammatory phase) during critical/severe COVID-19 pneumonia. Despite contradictory results, the benefits of TCZ appear significant, especially in combination with add-on therapies, such as corticosteroids. Although the safety of TCZ is acceptable, solid data is lacking as to its benefits during pregnancy. There are limited data on TCZ combination therapies, such as hemoperfusion, intravenous immunoglobulin (IVIG), simple O2 therapy, vasopressor support, convalescent plasma therapy, and even in vaccinated patients and COVID-19 reinfection, especially in elderly persons. In addition, the impact of TCZ therapy on the long-lasting COVID-19 is unclear.
Conclusion: Personalized medicine based on individual characteristics and pertinent clinical conditions must be considered in the clinicians' decision-making policy. Finally, to mitigate the risk-to-benefit ratio of TCZ, a treatment algorithm, based on available literature and updated national institute of health (NIH) and Infectious Diseases Society of America (IDSA) guidelines, is also proposed.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239185 | PMC |
| http://dx.doi.org/10.22037/aaem.v12i1.2217 | DOI Listing |
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