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

@unpublished{Godolphin:2022:10.1101/2021.08.26.21262523,
author = {Godolphin, P and Fisher, D and Berry, L and Derde, LPG and Diaz, J and Gordon, A and Lorenzi, E and Marshall, J and Murthy, S and Shankar-Hari, M and Sterne, JAC and Tierney, J and Vale, C},
doi = {10.1101/2021.08.26.21262523},
publisher = {MedArxiv},
title = {Association between tocilizumab, sarilumab and all-cause mortality at 28 days in hospitalized patients with COVID-19: A network meta-analysis},
url = {http://dx.doi.org/10.1101/2021.08.26.21262523},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - UNPB
AB  - <h4>Objective: </h4> To estimate pairwise associations between administration of tocilizumab, sarilumab and usual care or placebo with 28-day mortality, in COVID-19 patients receiving concomitant corticosteroids and non-invasive or mechanical ventilation, based on all available direct and indirect evidence. <h4>Methods:</h4> Eligible trials randomized hospitalized patients with COVID-19 that compared either interleukin-6 receptor antagonist with usual care or placebo in a recent prospective meta-analysis (27 trials, 10930 patients) or that directly compared tocilizumab with sarilumab. Data were restricted to patients receiving corticosteroids and either non-invasive or invasive ventilation at randomization. Pairwise associations between tocilizumab, sarilumab and usual care or placebo for all-cause mortality 28 days after randomization were estimated using a frequentist contrast-based network meta-analysis of odds ratios (ORs), implementing multivariate fixed-effects models that assume consistency between the direct and indirect evidence. <h4>Results:</h4> One trial (REMAP-CAP) was identified that directly compared tocilizumab with sarilumab and supplied results on all-cause mortality at 28-days. This network meta-analysis was based on 898 eligible patients (278 deaths) from REMAP-CAP and 3710 eligible patients from 18 trials (1278 deaths) from the prospective meta-analysis. Summary ORs were similar for tocilizumab [0.82 [0.71-0.95, P=0.008]] and sarilumab [0.80 [0.61-1.04, P=0.09]] compared with usual care or placebo. The summary OR for 28-day mortality comparing tocilizumab with sarilumab was 1.03 [95%CI 0.81-1.32, P=0.80]. The P value for the global test for inconsistency was 0.28. <h4>Conclusion:</h4> Administration of either tocilizumab or sarilumab was associated with lower 28-day all-cause mortality compared with usual care or placebo. The association is not dependent on the choice of interleukin-6 receptor anta
AU  - Godolphin,P
AU  - Fisher,D
AU  - Berry,L
AU  - Derde,LPG
AU  - Diaz,J
AU  - Gordon,A
AU  - Lorenzi,E
AU  - Marshall,J
AU  - Murthy,S
AU  - Shankar-Hari,M
AU  - Sterne,JAC
AU  - Tierney,J
AU  - Vale,C
DO  - 10.1101/2021.08.26.21262523
PB  - MedArxiv
PY  - 2022///
TI  - Association between tocilizumab, sarilumab and all-cause mortality at 28 days in hospitalized patients with COVID-19: A network meta-analysis
UR  - http://dx.doi.org/10.1101/2021.08.26.21262523
UR  - https://www.medrxiv.org/content/10.1101/2021.08.26.21262523v1
UR  - http://hdl.handle.net/10044/1/97286
ER  -
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