To compare the efficacy of olokizumab and tocilizumab in reducing the risk of invasive mechanical ventilation or death in hospitalized patients with COVID-19.
Material and methods
In a retrospective study, we recruited all consecutive hospitalized patients with COVID-19, who were treated with subcutaneous olokizumab or intravenous tocilizumab. The primary outcome of the study was a composite of all-cause death or invasive mechanical ventilation during hospitalization, whereas the secondary outcomes were in-hospital all-cause mortality, the requirement for invasive mechanical ventilation and the length of hospital stay. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated with multivariated logistic regression analysis.
Overall, 244 hospitalized COVID-19 patients were treated with at least one subcutaneous olokizumab injection (n=157) or intravenous tocilizumab infusion (n=87). Most patients in both groups were elderly or very elderly and had various cardiovascular and other comorbidities. All patients presented with signs and symptoms of hyperinflammatory immune response, and 197 (80.7%) patients required oxygen prior to study drug administration. Both primary and secondary study outcomes occurred with a similar frequency in olokizumab and tocilizumab groups. In multivariate regression analysis, the HR for the primary outcome was 0.58 (95% CI 0.27-1.23). Median length of hospital stay was equal in the two groups (16 days).
Our findings suggest similar efficacy of subcutaneous olokizumab and intravenous tocilizumab in reducing the risk of death or invasive mechanical ventilation in patients with SARS-CoV-2 induced hyperinflammatory immune response.
COVID-19, hyperinflammatory immune response, IL6 inhibitors, olokizumab, tocilizumab, intubation, death.