Real World Long-term Assessment of The Efficacy of Tocilizumab in Patients with COVID-19: Results From A Large De-identified Multicenter Electronic Health Record Dataset in the United States

Masayuki Nigo, Laila Rasmy, Sarah B. May, Aishwarya Rao, Sam Karimaghaei, Bijun Sai Kannadath, Alejandro De la Hoz, Cesar A. Arias, Liang Li, Degui Zhi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Studies have shown conflicting results on the efficacy of tocilizumab (TCZ) for patients with COVID-19, with many confounders of clinical status and limited duration of the observation. Here, we evaluate the real-world long-term efficacy of TCZ in COVID-19 patients. Methods: We conducted a retrospective study of hospitalized adult patients with COVID-19 using a large US-based multicenter COVID-19 database (Cerner Real-World Data; updated in September, 2020). The TCZ group was defined as patients who received at least one dose of the drug. Matching weight (MW) and a propensity score weighting method were used to balance confounding factors. Results: A total of 20,399 patients were identified. 1,510 and 18,899 were in the TCZ and control groups, respectively. After MW adjustment, no statistically significant differences in all-cause mortality were found for the TCZ vs. control group (Hazard Ratio [HR]:0.76, p=0.06). Survival curves suggested a better trend in short-term observation, driven from a subgroup of patients requiring oxygen masks, BIPAP or CPAP. Conclusion: We observed a temporal (early) benefit of TCZ, especially in patients on non-invasive high-flow supplemental oxygen. However, the benefit effects faded with longer observation. The long-term benefits and risks of TCZ should be carefully evaluated with follow-up studies.

Original languageEnglish (US)
Pages (from-to)148-154
Number of pages7
JournalInternational Journal of Infectious Diseases
Volume113
DOIs
StatePublished - Dec 2021
Externally publishedYes

Keywords

  • COVID-19
  • De-identified Database
  • Tocilizumab

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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