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{Godolphin:2022:10.1371/journal.pone.0270668,
author = {Godolphin, PJ and Fisher, DJ and Berry, LR and Derde, LPG and Diaz, JV and Gordon, AC and Lorenzi, E and Marshall, JC and Murthy, S and Shankar-Hari, M and Sterne, JAC and Tierney, JF and Vale, CL},
doi = {10.1371/journal.pone.0270668},
journal = {PLoS One},
pages = {1--13},
title = {Association between tocilizumab, sarilumab and all-cause mortality at 28 days in hospitalised patients with COVID-19: A network meta-analysis},
url = {http://dx.doi.org/10.1371/journal.pone.0270668},
volume = {17},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundA recent prospective meta-analysis demonstrated that interleukin-6 antagonists are associated with lower all-cause mortality in hospitalised patients with COVID-19, compared with usual care or placebo. However, emerging evidence suggests that clinicians are favouring the use of tocilizumab over sarilumab. A new randomised comparison of these agents from the REMAP-CAP trial shows similar effects on in-hospital mortality. Therefore, we initiated a network meta-analysis, to estimate pairwise associations between tocilizumab, sarilumab and usual care or placebo with 28-day mortality, in COVID-19 patients receiving concomitant corticosteroids and ventilation, based on all available direct and indirect evidence.MethodsEligible trials randomised hospitalised patients with COVID-19 that compared tocilizumab or sarilumab with usual care or placebo in the prospective meta-analysis or that directly compared tocilizumab with sarilumab. Data were restricted to patients receiving corticosteroids and either non-invasive or invasive ventilation at randomisation.Pairwise associations between tocilizumab, sarilumab and usual care or placebo for all-cause mortality 28 days after randomisation 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.FindingsOne 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 com
AU  - Godolphin,PJ
AU  - Fisher,DJ
AU  - Berry,LR
AU  - Derde,LPG
AU  - Diaz,JV
AU  - Gordon,AC
AU  - Lorenzi,E
AU  - Marshall,JC
AU  - Murthy,S
AU  - Shankar-Hari,M
AU  - Sterne,JAC
AU  - Tierney,JF
AU  - Vale,CL
DO  - 10.1371/journal.pone.0270668
EP  - 13
PY  - 2022///
SN  - 1932-6203
SP  - 1
TI  - Association between tocilizumab, sarilumab and all-cause mortality at 28 days in hospitalised patients with COVID-19: A network meta-analysis
T2  - PLoS One
UR  - http://dx.doi.org/10.1371/journal.pone.0270668
UR  - https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0270668
UR  - http://hdl.handle.net/10044/1/98463
VL  - 17
ER  -
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