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Effectiveness of tocilizumab in patients hospitalized with COVID-19: A follow-up of the CORIMUNO-TOCI-1 randomized clinical trial

JAMA May 29, 2021

Mariette X, Hermine O, Tharaux PL, et al. - Previously, a trial of tocilizumab in hospitalized patients who were receiving oxygen (rate, ≥ 3 L/min) but did not require high-flow or mechanical ventilation was published by researchers. The primary composite endpoint was met in this study, which was the proportion of patients who necessitated noninvasive ventilation or intubation or who died at day 14 was, but survival difference was not observed at day 28. Researchers conducted this follow-up analysis with the aim to extend follow-up to 90 days and investigated if survival varied with baseline CRP levels. By day 90, 7 of 63 (11%) and 11 of 67 patients (18%) in the tocilizumab and usual care arms, respectively, had died. On analyzing outcomes according to CRP levels, a statistical interaction was identified between CRP levels and the primary composite endpoint at day 14 and survival at day 90, with a benefit of tocilizumab in patients with CRP levels greater than 15.0 mg/dL (to convert to mg/L, multiply by 10), but not in those with CRP levels 15.0 mg/dL or less. Overall outcomes suggest that consideration can be given to tocilizumab for treating patients with moderate-to-severe COVID-19–associated pneumonia and high CRP levels.

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