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

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...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Tocilizumab COVID-19 De-identified Database Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/b999958492c148f98c3cedd11fa10a1c
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b999958492c148f98c3cedd11fa10a1c
record_format	dspace
spelling	oai:doaj.org-article:b999958492c148f98c3cedd11fa10a1c2021-11-06T04:22:44ZReal 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 States1201-971210.1016/j.ijid.2021.09.067https://doaj.org/article/b999958492c148f98c3cedd11fa10a1c2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1201971221007748https://doaj.org/toc/1201-9712Background: 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.Masayuki NigoLaila RasmySarah B. MayAishwarya RaoSam KarimaghaeiBijun Sai KannadathAlejandro De la HozCesar A. AriasLiang LiDegui ZhiElsevierarticleTocilizumabCOVID-19De-identified DatabaseInfectious and parasitic diseasesRC109-216ENInternational Journal of Infectious Diseases, Vol 113, Iss , Pp 148-154 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Tocilizumab COVID-19 De-identified Database Infectious and parasitic diseases RC109-216
spellingShingle	Tocilizumab COVID-19 De-identified Database Infectious and parasitic diseases RC109-216 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 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
description	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.
format	article
author	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
author_facet	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
author_sort	Masayuki Nigo
title	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
title_short	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
title_full	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
title_fullStr	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
title_full_unstemmed	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
title_sort	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
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/b999958492c148f98c3cedd11fa10a1c
work_keys_str_mv	AT masayukinigo realworldlongtermassessmentoftheefficacyoftocilizumabinpatientswithcovid19resultsfromalargedeidentifiedmulticenterelectronichealthrecorddatasetintheunitedstates AT lailarasmy realworldlongtermassessmentoftheefficacyoftocilizumabinpatientswithcovid19resultsfromalargedeidentifiedmulticenterelectronichealthrecorddatasetintheunitedstates AT sarahbmay realworldlongtermassessmentoftheefficacyoftocilizumabinpatientswithcovid19resultsfromalargedeidentifiedmulticenterelectronichealthrecorddatasetintheunitedstates AT aishwaryarao realworldlongtermassessmentoftheefficacyoftocilizumabinpatientswithcovid19resultsfromalargedeidentifiedmulticenterelectronichealthrecorddatasetintheunitedstates AT samkarimaghaei realworldlongtermassessmentoftheefficacyoftocilizumabinpatientswithcovid19resultsfromalargedeidentifiedmulticenterelectronichealthrecorddatasetintheunitedstates AT bijunsaikannadath realworldlongtermassessmentoftheefficacyoftocilizumabinpatientswithcovid19resultsfromalargedeidentifiedmulticenterelectronichealthrecorddatasetintheunitedstates AT alejandrodelahoz realworldlongtermassessmentoftheefficacyoftocilizumabinpatientswithcovid19resultsfromalargedeidentifiedmulticenterelectronichealthrecorddatasetintheunitedstates AT cesaraarias realworldlongtermassessmentoftheefficacyoftocilizumabinpatientswithcovid19resultsfromalargedeidentifiedmulticenterelectronichealthrecorddatasetintheunitedstates AT liangli realworldlongtermassessmentoftheefficacyoftocilizumabinpatientswithcovid19resultsfromalargedeidentifiedmulticenterelectronichealthrecorddatasetintheunitedstates AT deguizhi realworldlongtermassessmentoftheefficacyoftocilizumabinpatientswithcovid19resultsfromalargedeidentifiedmulticenterelectronichealthrecorddatasetintheunitedstates
_version_	1718443939447439360

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

Ejemplares similares