• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

RECOVERY Trial: Does Tocilizumab Reduce Mortality in Hospitalized COVID-19 Patients?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Tocilizumab is a monoclonal antibody that can reduce inflammation and may be beneficial for treating severe COVID-19
  • The RECOVERY Collaborative Group (The Lancet, 2021) evaluated the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation

METHODS:

  • Randomized, controlled, open-label, platform trial
    • Randomized Evaluation of COVID-19 Therapy (RECOVERY), which assesses several possible COVID-19 treatments
  • Setting
    • UK
    • Between April 23, 2020 and Jan 24, 2021
  • Participants
    • Patients hospitalized with COVID-19
    • Hypoxia: oxygen saturation <92% on air or requiring oxygen therapy and
    • Evidence of systemic inflammation: C-reactive protein ≥75 mg/L
  • Interventions (1:1 randomization)
    • Standard care alone
    • Standard care plus intravenous tocilizumab at a dose of 400 mg to 800 mg (depending on weight)
      • A second dose could be given 12 to 24 h later if the patient’s condition had not improved
  • Primary outcome
    • 28-day mortality, assessed in the intention-to-treat population

RESULTS:

  • Tocilizumab: 2022 patients | Usual care: 2094 patient
    • Also received systemic corticosteroids: 82%
  • 28-day mortality was lower in the tocilizumab group
    • Tocilizumab: 31%
    • Usual care: 35%
    • Rate ratio 0.85 (95% CI, 0.76 to 0.94; p = 0.0028)
  • Subgroup analysis
    • Results consistent across all analyses, including those receiving systemic corticosteroids
  • Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days
    • Tocilizumab: 57%
    • Usual care: 50%
    • Rate ratio 1.22 (95% CI, 1.12 to 1.33; p < 0.0001)
  • Not receiving invasive mechanical ventilation at baseline
    • Patients in tocilizumab group were less likely to reach a composite endpoint of invasive mechanical ventilation or death
    • Tocilizumab: 35%
    • Usual care: 42%
    • Risk ratio 0.84 (95% CI, 0.77 to 0.92; p < 0.0001)

CONCLUSION:

  • For patients hospitalized with hypoxia and systemic inflammation associated with COVID-19, tocilizumab reduced 28-day mortality, and increased the likelihood of discharge from the hospital by 28-days
  • Benefit was seen whether the patient was on mechanical ventilation or systemic corticosteroids
  • The authors state

The RECOVERY trial has shown that for patients hospitalised with severe COVID-19, treatment with tocilizumab reduces mortality, increases the chances of successful hospital discharge, and reduces the chances of requiring invasive mechanical ventilation

These findings require an update to clinical guidelines, which has already begun, and efforts to increase the global availability and affordability of tocilizumab

Learn More – Primary Sources:

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Get Mobile-Friendly COVID-19 Research Summaries with ObGFirst

ObGFirst® – Try It Free! »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Neutralizing Antibody Medication for Outpatient COVID-19: Interim Results from the BLAZE-1 RCT
Remdesivir RCT Results: 5 or 10 Day Treatment for Severe COVID-19?
Does Prophylactic Anticoagulation Reduce Mortality in Hospitalized COVID-19 Patients?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site