@article{Domingo:2021:10.1001/jama.2021.11330,
author = {Domingo, P and Mur, I and Mateo, GM and Gutierrez, MDM and Pomar, V and de, Benito N and Corbacho, N and Herrera, S and Millan, L and Muñoz, J and Malouf, J and Molas, ME and Asensi, V and Horcajada, JP and Estrada, V and Gutierrez, F and Torres, F and Perez-Molina, JA and Fortun, J and Villar, LM and Hohenthal, U and Marttila, H and Vuorinen, T and Nordberg, M and Valtonen, M and Frigault, MJ and Mansour, MK and Patel, NJ and Fernandes, A and Harvey, L and Foulkes, AS and Healy, BC and Shah, R and Bensaci, AM and Woolley, AE and Nikiforow, S and Lin, N and Sagar, M and Shrager, H and Huckins, DS and Axelrod, M and Pincus, MD and Fleisher, J and Lampa, J and Nowak, P and Vesterbacka, JC and Rasmuson, J and Skorup, P and Janols, H and Niward, KF and Chatzidionysiou, K and Asgeirsson, H and Parke, Å and Blennow, O and Svensson, A-K and Aleman, S and Sönnerborg, A and Henter, J-I and Horne, AC and Al-Beidh, F and Angus, D and Annane, D and Arabi, Y and Beane, A and Berry, S and Bhimani, Z},
doi = {10.1001/jama.2021.11330},
journal = {JAMA},
title = {Association between administration of IL-6 antagonists and mortality among patients hospitalized for COVID-19},
url = {http://dx.doi.org/10.1001/jama.2021.11330},
year = {2021}
}

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TY  - JOUR
AB  - Importance  Clinical trials assessing the efficacy of IL-6 antagonists in patients hospitalized for COVID-19 have variously reported benefit, no effect, and harm.Objective  To estimate the association between administration of IL-6 antagonists compared with usual care or placebo and 28-day all-cause mortality and other outcomes.Data Sources  Trials were identified through systematic searches of electronic databases between October 2020 and January 2021. Searches were not restricted by trial status or language. Additional trials were identified through contact with experts.Study Selection  Eligible trials randomly assigned patients hospitalized for COVID-19 to a group in whom IL-6 antagonists were administered and to a group in whom neither IL-6 antagonists nor any other immunomodulators except corticosteroids were administered. Among 72 potentially eligible trials, 27 (37.5%) met study selection criteria.Data Extraction and Synthesis  In this prospective meta-analysis, risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool. Inconsistency among trial results was assessed using the I2 statistic. The primary analysis was an inverse variance–weighted fixed-effects meta-analysis of odds ratios (ORs) for 28-day all-cause mortality.Main Outcomes and Measures  The primary outcome measure was all-cause mortality at 28 days after randomization. There were 9 secondary outcomes including progression to invasive mechanical ventilation or death and risk of secondary infection by 28 days.Results  A total of 10930 patients (median age, 61 years [range of medians, 52-68 years]; 3560 [33%] were women) participating in 27 trials were included. By 28 days, there were 1407 deaths among 6449 patients randomized to IL-6 antagonists and 1158 deaths among 4481 patients randomized to usual care or placebo (summary OR, 0.86 [95% CI, 0.79-0.95]; P = .003 based on a fixed-effects meta-analysis). This corresponds to an absolute mortality risk of 22% for IL
AU  - Domingo,P
AU  - Mur,I
AU  - Mateo,GM
AU  - Gutierrez,MDM
AU  - Pomar,V
AU  - de,Benito N
AU  - Corbacho,N
AU  - Herrera,S
AU  - Millan,L
AU  - Muñoz,J
AU  - Malouf,J
AU  - Molas,ME
AU  - Asensi,V
AU  - Horcajada,JP
AU  - Estrada,V
AU  - Gutierrez,F
AU  - Torres,F
AU  - Perez-Molina,JA
AU  - Fortun,J
AU  - Villar,LM
AU  - Hohenthal,U
AU  - Marttila,H
AU  - Vuorinen,T
AU  - Nordberg,M
AU  - Valtonen,M
AU  - Frigault,MJ
AU  - Mansour,MK
AU  - Patel,NJ
AU  - Fernandes,A
AU  - Harvey,L
AU  - Foulkes,AS
AU  - Healy,BC
AU  - Shah,R
AU  - Bensaci,AM
AU  - Woolley,AE
AU  - Nikiforow,S
AU  - Lin,N
AU  - Sagar,M
AU  - Shrager,H
AU  - Huckins,DS
AU  - Axelrod,M
AU  - Pincus,MD
AU  - Fleisher,J
AU  - Lampa,J
AU  - Nowak,P
AU  - Vesterbacka,JC
AU  - Rasmuson,J
AU  - Skorup,P
AU  - Janols,H
AU  - Niward,KF
AU  - Chatzidionysiou,K
AU  - Asgeirsson,H
AU  - Parke,Å
AU  - Blennow,O
AU  - Svensson,A-K
AU  - Aleman,S
AU  - Sönnerborg,A
AU  - Henter,J-I
AU  - Horne,AC
AU  - Al-Beidh,F
AU  - Angus,D
AU  - Annane,D
AU  - Arabi,Y
AU  - Beane,A
AU  - Berry,S
AU  - Bhimani,Z
AU  - Bonten,M
AU  - Bradbury,C
AU  - Brunkhorst,F
AU  - Buxton,M
AU  - Cheng,A
AU  - Cove,M
AU  - De,Jong M
AU  - Derde,L
AU  - Estcourt,L
AU  - Goossens,H
AU  - Gordon,A
AU  - Green,C
AU  - Haniffa,R
AU  - Ichihara,N
AU  - Lamontagne,F
AU  - Lawler,P
AU  - Litton,E
AU  - Marshall,J
AU  - McArthur,C
AU  - McAuley,D
AU  - McGuinness,S
AU  - McVerry,B
AU  - Montgommery,S
AU  - Mouncey,P
AU  - Murthy,S
AU  - Nichol,A
AU  - Parke,R
AU  - Parker,J
AU  - Reyes,F
AU  - Rowan,K
AU  - Saito,H
AU  - Santos,M
AU  - Seymour,C
AU  - Shankar-Hari,M
AU  - Turgeon,A
AU  - Turner,A
AU  - van,Bentum-Puijk W
AU  - van,de Veerdonk F
AU  - Webb,S
AU  - Zarychanski,R
AU  - Baillie,JK
AU  - Beasley,R
AU  - Cooper,N
AU  - Fowler,R
AU  - Galea,J
AU  - Hills,T
AU  - King,A
AU  - Morpeth,S
AU  - Netea,M
AU  - Ogungbenro,K
AU  - Pettila,V
AU  - Tong,S
AU  - Uyeki,T
AU  - Youngstein,T
AU  - Higgins,A
AU  - Lorenzi,E
AU  - Berry,L
AU  - Salama,C
AU  - Rosas,IO
AU  - Ruiz-Antorán,B
AU  - Muñez,Rubio E
AU  - Ramos,Martínez A
AU  - Campos,Esteban J
AU  - Avendaño,Solá C
AU  - Pizov,R
AU  - Sanz,Sanz J
AU  - Abad-Santos,F
AU  - Bautista-Hernández,A
AU  - García-Fraile,L
AU  - Barrios,A
AU  - Gutiérrez,Liarte Á
AU  - Alonso,Pérez T
AU  - Rodríguez-García,SC
AU  - Mejía-Abril,G
AU  - Prieto,JC
AU  - Leon,R
AU  - VEIGA,VC
AU  - SCHEINBERG,P
AU  - FARIAS,DLC
AU  - PRATS,JG
AU  - CAVALCANTI,AB
AU  - MACHADO,FR
AU  - ROSA,RG
AU  - BERWANGER,O
AU  - AZEVEDO,LCP
AU  - LOPES,RD
AU  - DOURADO,LK
AU  - CASTRO,CG
AU  - ZAMPIERI,FG
AU  - AVEZUM,A
AU  - LISBOA,TC
AU  - ROJAS,SSO
AU  - COELHO,JC
AU  - LEITE,RT
AU  - CARVALHO,JC
AU  - ANDRADE,LEC
AU  - SANDES,AR
AU  - PINTÃO,MCT
AU  - SANTOS,SV
AU  - ALMEIDA,TML
AU  - COSTA,AN
AU  - GEBARA,OCE
AU  - FREITAS,FGR
AU  - PACHECO,ES
AU  - MACHADO,DJB
AU  - MARTIN
DO  - 10.1001/jama.2021.11330
PY  - 2021///
SN  - 0098-7484
TI  - Association between administration of IL-6 antagonists and mortality among patients hospitalized for COVID-19
T2  - JAMA
UR  - http://dx.doi.org/10.1001/jama.2021.11330
UR  - https://jamanetwork.com/journals/jama/fullarticle/2781880
ER  - 

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