RT Journal Article
T1 Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19: A Meta-analysis.
A1 Shankar-Hari, Manu
A1 Vale, Claire L
A1 Godolphin, Peter J
A1 Fisher, David
A1 Higgins, Julian P T
A1 Spiga, Francesca
A1 Savovic, Jelena
A1 Tierney, Jayne
A1 Baron, Gabriel
A1 Benbenishty, Julie S
A1 Berry, Lindsay R
A1 Broman, Niklas
A1 Cavalcanti, Alexandre Biasi
A1 Colman, Roos
A1 De Buyser, Stefanie L
A1 Derde, Lennie P G
A1 Domingo, Pere
A1 Omar, Sharifah Faridah
A1 Fernandez-Cruz, Ana
A1 Feuth, Thijs
A1 Garcia, Felipe
A1 Garcia-Vicuna, Rosario
A1 Gonzalez-Alvaro, Isidoro
A1 Gordon, Anthony C
A1 Haynes, Richard
A1 Hermine, Olivier
A1 Horby, Peter W
A1 Horick, Nora K
A1 Kumar, Kuldeep
A1 Lambrecht, Bart N
A1 Landray, Martin J
A1 Leal, Lorna
A1 Lederer, David J
A1 Lorenzi, Elizabeth
A1 Mariette, Xavier
A1 Merchante, Nicolas
A1 Misnan, Nor Arisah
A1 Mohan, Shalini V
A1 Nivens, Michael C
A1 Oksi, Jarmo
A1 Perez-Molina, Jose A
A1 Pizov, Reuven
A1 Porcher, Raphael
A1 Postma, Simone
A1 Rajasuriar, Reena
A1 Ramanan, Athimalaipet V
A1 Ravaud, Philippe
A1 Reid, Pankti D
A1 Rutgers, Abraham
A1 Sancho-Lopez, Aranzazu
A1 Seto, Todd B
A1 Sivapalasingam, Sumathi
A1 Soin, Arvinder Singh
A1 Staplin, Natalie
A1 Stone, John H
A1 Strohbehn, Garth W
A1 Sunden-Cullberg, Jonas
A1 Torre-Cisneros, Julian
A1 Tsai, Larry W
A1 van-Hoogstraten, Hubert
A1 van-Meerten, Tom
A1 Cordeiro-Veiga, Viviane
A1 Westerweel, Peter E
A1 Murthy, Srinivas
A1 Diaz, Janet V
A1 Marshall, John C
A1 Sterne, Jonathan A C
K1 Antibodies, monoclonal, humanized
K1 COVID-19
K1 Cause of death
K1 Coinfection
K1 Disease progression
AB Clinical trials assessing the efficacy of IL-6 antagonists in patients hospitalized for COVID-19 have variously reported benefit, no effect, and harm. 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. 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. 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. 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. 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. A total of 10 930 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-6 antagonists compared with an assumed mortality risk of 25% for usual care or placebo. The corresponding summary ORs were 0.83 (95% CI, 0.74-0.92; P  In this prospective meta-analysis of clinical trials of patients hospitalized for COVID-19, administration of IL-6 antagonists, compared with usual care or placebo, was associated with lower 28-day all-cause mortality. 
PB American Medical Association
YR 2021
FD 2021-07-06
LK http://hdl.handle.net/10668/18167
UL http://hdl.handle.net/10668/18167
LA en
NO WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group; Shankar-Hari M, Vale CL, Godolphin PJ, Fisher D, Higgins JPT, et al.  Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19: A Meta-analysis. JAMA. 2021 Aug 10;326(6):499-518
DS RISalud
RD Apr 6, 2025