anti-interleukin-6 for COVID-19: living meta-analysis of clinical studies

Study explorer (study characteristics and results) method abbreviations pdf xlsx

display ongoing studies
Study	Ref.	Design	studied treatment	control treatment	patients	study risk of bias	sample sizes	Results
COVID 19 hospitalized meta-analysis
CORIMUNO-SARI-1 (non ICU) NCT04324073		RCT	sarilumab	standard of care	COVID 19 hospitalized	some concern	68/80	inconclusive	inconclusive 1 % increase in clinical deterioration (PE) with a moderate degree of certainty due to some concern in risk of bias inconclusive 12 % increase in death or ventilation (PE) with a moderate degree of certainty due to some concern in risk of bias
Declercq J (COV-AID) NCT04330638		RCT	tocilizumab	standard of care	COVID 19 hospitalized	low	114/115	inconclusive
RCT-TCZ-COVID-19 NCT04346355		RCT	tocilizumab	standard of care	COVID 19 hospitalized	some concern	60/66	inconclusive
RECOVERY NCT04381936		RCT	tocilizumab	standard of care	COVID 19 hospitalized	some concern	2022/2094	conclusif	demonstrated 15 % decrease in deaths (PE) with a moderate degree of certainty due to some concern in risk of bias suggested 15 % decrease in death or ventilation with a moderate degree of certainty due to some concern in risk of bias
Rutgers		RCT	tocilizumab	standard of care	COVID 19 hospitalized	some concern	174/180	suggested	inconclusive 41 % decrease in death D28 (PE) with a moderate degree of certainty due to some concern in risk of bias suggested 35 % decrease in death or ventilation with a moderate degree of certainty due to some concern in risk of bias
Soin AS (COVINTOC) CTRI/2020/05/025369		RCT	tocilizumab	standard of care	COVID 19 hospitalized	some concern	90/90	inconclusive
Dongsheng Wang ChiCTR2000029765		RCT	tocilizumab	standard of care	COVID 19 hospitalized	some concern	33/32	safety concern	statistically significant 8.6-fold increase in adverse events with a moderate degree of certainty due to some concern in risk of bias
EMPACTA NCT04372186		RCT	tocilizumab	placebo	COVID 19 hospitalized	some concern	259/129	conclusif	demonstrated 44 % decrease in death or ventilation (PE) with a moderate degree of certainty due to some concern in risk of bias suggested 45 % decrease in clinical deterioration with a moderate degree of certainty due to some concern in risk of bias
EU-CTR2020-001375-32 (PreToVid) unpublished EU-CTR2020-001375-32		RCT	tocilizumab	standard of care	COVID 19 hospitalized	low	174/180	inconclusive
EU-CTR2020-001748-24 (ImmCoVA) unpublished EU-CTR2020-001748-24		RCT	tocilizumab	standard of care	COVID 19 hospitalized	low	22/27	inconclusive
NCT04412772 (ARCHITECTS) unpublished NCT04412772		RCT	tocilizumab	placebo	COVID 19 hospitalized	low	10/11	inconclusive
NCT04434717 (COVITOZ-1 single dose plus two doses) unpublished NCT04434717		RCT	tocilizumab	standard of care	COVID 19 hospitalized	low	17/9	inconclusive
NCT04479358 (COVIDOSE-2 substudy A 120mg plus 40mg) unpublished NCT04479358		RCT	tocilizumab	standard of care	COVID 19 hospitalized	low	20/8	inconclusive
NCT04577534 (COVIDSTORM) unpublished NCT04577534		RCT	tocilizumab	standard of care	COVID 19 hospitalized	low	26/13	inconclusive
Colaneri		OBS	tocilizumab	control	COVID 19 hospitalized	critical	21/21	inconclusive
HNF Hospital Tocilizumab multidisciplinary team		OBS	tocilizumab	control	COVID 19 hospitalized	critical	20/25	suggested	suggested 87 % decrease in death or transfer to ICU but with a very low degree of certainty due to critical risk of bias
Martinez-Sanz		OBS	tocilizumab	control	COVID 19 hospitalized	critical	260/969	suggested	suggested 66 % decrease in deaths but with a very low degree of certainty due to critical risk of bias
Tsai		OBS	tocilizumab	control	COVID 19 hospitalized	serious	66/66	inconclusive
COVID 19 all comers meta-analysis
BACC Bay Tocilizumab Trial NCT04356937		RCT	tocilizumab	placebo	COVID 19 all comers	low	161/81	inconclusive	inconclusive 17 % decrease in death or ventilation (PE) with a high degree of certainty due to low risk of bias
TOCOVID unpublished NCT04332094		RCT	tocilizumab	standard of care	COVID 19 all comers	NA	136/134	inconclusive
COVID-19 mild to moderate meta-analysis
Capra		OBS	tocilizumab	control	COVID-19 mild to moderate	critical	62/23	suggested	suggested 96 % decrease in deaths,deaths (time to event analysis only) but with a very low degree of certainty due to critical risk of bias
COVID-19 severe or critically meta-analysis
Hamed		RCT	tocilizumab	standard of care	COVID-19 severe or critically	high	26/23	inconclusive	inconclusive 83 % increase in deaths (PE) but with a low degree of certainty due to high risk of bias inconclusive 2.2-fold increase in ICU admission (PE) but with a low degree of certainty due to high risk of bias
MARIPOSA NCT04363736		RCT	tocilizumab	tocilizumab	COVID-19 severe or critically	some concern	48/49	inconclusive	A trend for increased progression toward worse clinical status (categories 5 and 6) and death (category 7) was seen up to day 14 for the 4-mg/kg vs 8-mg/ kg group, followed by no notable difference between groups at days 21 and 28.
Rashad NCT04519385		RCT	tocilizumab	dexamethasone	COVID-19 severe or critically	high	74/75	safety concern	statistically significant 1.2-fold increase in deaths,deaths (time to event analysis only) (PE) but with a low degree of certainty due to high risk of bias statistically significant 1.9-fold increase in death D28 but with a low degree of certainty due to high risk of bias
REMAP-CAP (tocilizumab) NCT02735707		RCT	tocilizumab	standard of care	COVID-19 severe or critically	some concern	353/402	conclusif	suggested 30 % decrease in deaths with a moderate degree of certainty due to some concern in risk of bias demonstrated 64 % increase in clinical improvement (PE) with a moderate degree of certainty due to some concern in risk of bias
REMAP-CAP sarilumab NCT02735707		RCT	sarilumab	standard of care	COVID-19 severe or critically	high	48/402	conclusif	demonstrated 76 % increase in clinical improvement (PE) but with a low degree of certainty due to high risk of bias suggested 86 % increase in clinical improvement (14-day) but with a low degree of certainty due to high risk of bias
Rosas (REMDACTA) NCT04409262		RCT	tocilizumab	placebo	COVID-19 severe or critically	some concern	434/215	inconclusive	inconclusive 3 % decrease in hospital discharge (PE) with a moderate degree of certainty due to some concern in risk of bias
Talaschian IRCT20081027001411N4		RCT	tocilizumab	standard of care	COVID-19 severe or critically	some concern	20/20	inconclusive
Veiga NCT04403685		RCT	tocilizumab	standard of care	COVID-19 severe or critically	some concern	65/64	safety concern	safety concern with 1.7-fold increase in deaths,death D28 (not statistically significant) inconclusive 54 % increase in death or ventilation (PE) with a moderate degree of certainty due to some concern in risk of bias
CORIMUNO-TOCI-1 (Group 1) NCT04331808		RCT	tocilizumab	standard of care	COVID-19 severe or critically	some concern	64/67	inconclusive
CORIMUNO-TOCI-ICU (Group 2) NCT04331808		RCT	tocilizumab	standard of care	COVID-19 severe or critically	some concern	49/43	inconclusive
COVACTA (Rosas) NCT04320615		RCT	tocilizumab	placebo	COVID-19 severe or critically	some concern	301/151	suggested	inconclusive 19 % increase in clinical improvement,clinical improvement (28-day) (PE) with a moderate degree of certainty due to some concern in risk of bias
NCT04377750 (HMO-0224-20) unpublished NCT04377750		RCT	tocilizumab	placebo	COVID-19 severe or critically	high	37/17	inconclusive
Andrew		OBS	tocilizumab	control	COVID-19 severe or critically	NA	198/413	inconclusive
ARI-RAF (Della-Torre)		OBS	sarilumab	control	COVID-19 severe or critically	NA	28/28	inconclusive
Biran		OBS	tocilizumab	control	COVID-19 severe or critically	serious	210/420	suggested	suggested 36 % decrease in deaths but with a low degree of certainty due to high risk of bias
Mathilde		OBS	tocilizumab	control	COVID-19 severe or critically	critical	30/29	suggested	suggested 75 % decrease in deaths but with a very low degree of certainty due to critical risk of bias
Rojas-Marte		OBS	tocilizumab	control	COVID-19 severe or critically	critical	96/97	inconclusive
Somers		OBS	tocilizumab	control	COVID-19 severe or critically	critical	78/76	safety concern	suggested 45 % decrease in deaths,deaths (time to event analysis only) but with a very low degree of certainty due to critical risk of bias statistically significant 2.3-fold increase in superinfection but with a very low degree of certainty due to critical risk of bias
TOCI-RAF Study Group (Campochiaro)		OBS	tocilizumab	control	COVID-19 severe or critically	NA	32/33	inconclusive

PE: primary endpoint; (a): to be demonstrated a result must be statistically significant on a primary endpoint (with multiplicity adjustment if necessary);
Study risk of bias assessed for the study primary endpoint(s) or the main endpoints in case of no formally defined primary endpoint(s).

Study explorer (study characteristics and results) method abbreviations pdf xlsx

COVID 19 hospitalized meta-analysis

COVID 19 all comers meta-analysis

COVID-19 mild to moderate meta-analysis

COVID-19 severe or critically meta-analysis