A Meta-analysis of the Risk of Secondary Infection of Tocilizumab in the Treatment of COVID-19

Ya LUO; Yanting YU; Xue ZHANG; Zhongjuan WANG

doi:10.12259/j.issn.2095-610X.S20240208

Volume 45 Issue 2

Feb. 2024

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Ya LUO, Yanting YU, Xue ZHANG, Zhongjuan WANG. A Meta-analysis of the Risk of Secondary Infection of Tocilizumab in the Treatment of COVID-19[J]. Journal of Kunming Medical University, 2024, 45(2): 57-64. doi: 10.12259/j.issn.2095-610X.S20240208

Citation:

Ya LUO, Yanting YU, Xue ZHANG, Zhongjuan WANG. A Meta-analysis of the Risk of Secondary Infection of Tocilizumab in the Treatment of COVID-19[J]. Journal of Kunming Medical University, 2024, 45(2): 57-64. doi: 10.12259/j.issn.2095-610X.S20240208

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A Meta-analysis of the Risk of Secondary Infection of Tocilizumab in the Treatment of COVID-19

doi: 10.12259/j.issn.2095-610X.S20240208

Ya LUO^1
,,
Yanting YU³,
Xue ZHANG^{2
,
,},
Zhongjuan WANG^{2
,
,}

1.
School of Pharmacy，Dali University，Dali Yunnan 671013
2.
Dept. of Pharmacy，Yan’an Hospital Affiliated to Kunming Medical University，Kunming Yunnan 650051
3.
Dept. of Emergency，The 3rd People’s Hospital of Kunming，Kunming Yunnan 650051，China

Received Date: 2023-10-24
Publish Date: 2024-02-25

Abstract

Abstract

Objective Meta-analysis was conducted to assess the risk of secondary infection caused by tocilizumab （TCZ） in the treatment of Corona Virus Disease 2019 （COVID-19）, in order to provide an evidence-based basis for the safety of tocilizumab in patients with COVID-19. Methods Cochrane Library, PubMed, Web of Science, CNKI, SinoMed and Wanfang databases were searched in computer to collect randomized controlled trial and cohort study of treating COVID-19 with tocilizumab from December 19, 2019 to December 30, 2022. A meta-analysis of the results of each study was performed using RevMan 5.4.1 software. Results A total of 1691 references were screened and eighteen studies involving 3933 patients were included. The incidence of secondary infection in the tocilizumab with the standard treatment group and standard treatment group was 19.14% （331/ 1729） and 12.11% （267/ 2204）, respectively. Meta-analysis showed that the tocilizumab + standard treatment group had a higher incidence of secondary infection than the standard treatment group [RR = 1.35, 95%CI （1.05, 1.74）, P = 0.02]. The results of the subgroup analysis showed that the risk of secondary infection with different doses of tocilizumab was different. The incidence of secondary infection was significantly higher in the subgroup with doses of 400～800 mg/d tocilizumab than in the standard care group [RR = 1.48, 95%CI （1.19, 1.84）, P = 0.0004]. The incidence of secondary infection in subgroups with doses of ≤400 mg/d tocilizumab was also significantly higher than that in the standard treatment group [RR = 1.87, 95%CI （1.28, 2.72）, P = 0.001]. However, there was no statistical significance between the subgroup 6～8 mg/kg tocilizumab and the standard treatment group. Conclusions Tocilizumab may increase the risk of secondary infection in patients with COVID-19 compared with standard treatment, and the benefits and risks of tocilizumab should be carefully evaluated before clinical administration. Moreover, large and high-quality studies are needed for further evaluation.
- Tocilizumab,
- COVID-19,
- Secondary infection,
- Meta-analysis

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References(31)

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