Imperial College London
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Professor Anthony Gordon

Faculty of Medicine, Department of Surgery & Cancer

Chair in Anaesthesia and Critical Care
 
 
 
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Contact

 

anthony.gordon

 
 
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Location

 

ICUQueen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Gordon:2021:10.1056/nejmoa2100433,
author = {Gordon, A and Mouncey, P and Al-Beidh, F and Rowan, K and Nichol, A and Arabi, Y and Annane, D and Beane, A and van, Bentum-Puijk W and Berry, L and Bhimani, Z and Bonten, M and Bradbury, C and Brunkhorst, F and Buzgau, A and Cheng, A and Detry, M and Duffy, E and Estcourt, L and Fitzgerald, M and Goossens, H and Haniffa, R and Higgins, A and Hills, T and Horvat, C and Lamontagne, F and Lawler, P and Leavis, H and Linstrum, K and Litton, E and Lorenzi, E and Marshall, J and Mayr, F and McAuley, D and McGlothlin, A and McGuinness, S and McVerry, B and Montgomery, S and Morpeth, S and Murthy, S and Orr, K and Parke, R and Parker, J and Patanwala, A and Pettilä, V and Rademaker, E and Santos, M and Saunders, C and Seymour, C and Shankar-Hari, M and Sligl, W and Turgeon, A and Turner, A and van, de Veerdonk F and Zarychanski, R and Green, C and Lewis, R and Angus, D and McArthur, C and Berry, S and Webb, S and Derde, L},
doi = {10.1056/nejmoa2100433},
journal = {New England Journal of Medicine},
pages = {1491--1502},
title = {Interleukin-6 receptor antagonists in critically Ill patients with Covid-19},
url = {http://dx.doi.org/10.1056/nejmoa2100433},
volume = {384},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUNDThe efficacy of interleukin-6 receptor antagonists in critically ill patients with coronavirus disease 2019 (Covid-19) is unclear.METHODSWe evaluated tocilizumab and sarilumab in an ongoing international, multifactorial, adaptive platform trial. Adult patients with Covid-19, within 24 hours after starting organ support in the intensive care unit (ICU), were randomly assigned to receive tocilizumab (8 mg per kilogram of body weight), sarilumab (400 mg), or standard care (control). The primary outcome was respiratory and cardiovascular organ support–free days, on an ordinal scale combining in-hospital death (assigned a value of −1) and days free of organ support to day 21. The trial uses a Bayesian statistical model with predefined criteria for superiority, efficacy, equivalence, or futility. An odds ratio greater than 1 represented improved survival, more organ support–free days, or both.RESULTSBoth tocilizumab and sarilumab met the predefined criteria for efficacy. At that time, 353 patients had been assigned to tocilizumab, 48 to sarilumab, and 402 to control. The median number of organ support–free days was 10 (interquartile range, −1 to 16) in the tocilizumab group, 11 (interquartile range, 0 to 16) in the sarilumab group, and 0 (interquartile range, −1 to 15) in the control group. The median adjusted cumulative odds ratios were 1.64 (95% credible interval, 1.25 to 2.14) for tocilizumab and 1.76 (95% credible interval, 1.17 to 2.91) for sarilumab as compared with control, yielding posterior probabilities of superiority to control of more than 99.9% and of 99.5%, respectively. An analysis of 90-day survival showed improved survival in the pooled interleukin-6 receptor antagonist groups, yielding a hazard ratio for the comparison with the control group of 1.61 (95% credible interval, 1.25 to 2.08) and a posterior probability of superiority of more than 99.9%. All secondary analyses supported efficacy of these interleuki
AU  - Gordon,A
AU  - Mouncey,P
AU  - Al-Beidh,F
AU  - Rowan,K
AU  - Nichol,A
AU  - Arabi,Y
AU  - Annane,D
AU  - Beane,A
AU  - van,Bentum-Puijk W
AU  - Berry,L
AU  - Bhimani,Z
AU  - Bonten,M
AU  - Bradbury,C
AU  - Brunkhorst,F
AU  - Buzgau,A
AU  - Cheng,A
AU  - Detry,M
AU  - Duffy,E
AU  - Estcourt,L
AU  - Fitzgerald,M
AU  - Goossens,H
AU  - Haniffa,R
AU  - Higgins,A
AU  - Hills,T
AU  - Horvat,C
AU  - Lamontagne,F
AU  - Lawler,P
AU  - Leavis,H
AU  - Linstrum,K
AU  - Litton,E
AU  - Lorenzi,E
AU  - Marshall,J
AU  - Mayr,F
AU  - McAuley,D
AU  - McGlothlin,A
AU  - McGuinness,S
AU  - McVerry,B
AU  - Montgomery,S
AU  - Morpeth,S
AU  - Murthy,S
AU  - Orr,K
AU  - Parke,R
AU  - Parker,J
AU  - Patanwala,A
AU  - Pettilä,V
AU  - Rademaker,E
AU  - Santos,M
AU  - Saunders,C
AU  - Seymour,C
AU  - Shankar-Hari,M
AU  - Sligl,W
AU  - Turgeon,A
AU  - Turner,A
AU  - van,de Veerdonk F
AU  - Zarychanski,R
AU  - Green,C
AU  - Lewis,R
AU  - Angus,D
AU  - McArthur,C
AU  - Berry,S
AU  - Webb,S
AU  - Derde,L
DO  - 10.1056/nejmoa2100433
EP  - 1502
PY  - 2021///
SN  - 0028-4793
SP  - 1491
TI  - Interleukin-6 receptor antagonists in critically Ill patients with Covid-19
T2  - New England Journal of Medicine
UR  - http://dx.doi.org/10.1056/nejmoa2100433
UR  - https://www.nejm.org/doi/10.1056/NEJMoa2100433
UR  - http://hdl.handle.net/10044/1/86283
VL  - 384
ER  -
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