Therapeutic Impact of Tocilizumab in the Setting of Severe COVID-19; an Updated and Comprehensive Review on Current Evidence

Rezabakhsh A, Ala A, Khodaei SH. Novel coronavirus (COVID-19): a new emerging pandemic threat. J Res Clin Med. 2020;8:5.

Rezabakhsh A, Mahdipour M, Nourazarian A, Habibollahi P, Sokullu E, Avci ÇB, et al. Application of exosomes for the alleviation of COVID‐19‐related pathologies. Cell Biochem Funct. 2022;40(5):430-8.

Sanaie S, Golipour E, Shamekh A, Sadaie MR, Mahmoodpoor A, Yousefi M. Immune response variables and viral mutations impact on COVID-19 reinfection and relapse. Int Immunopharmacol. 2021;100:108108.

Soleimanpour H, Sarbazi E, Esmaeili ED, Mehri A, Fam SG, Nikbakht HA, et al. Predictors of receiving COVID-19 vaccine among adult population in Iran: an observational study. BMC Public Health. 2023;23(1):490.

Tahsini Tekantapeh S, Ghojazadeh M, Ghamari AA, Mohammadi A, Soleimanpour H. Therapeutic and anti-inflammatory effects of baricitinib on mortality, ICU transfer, clinical improvement, and CRS-related laboratory parameters of hospitalized patients with moderate to severe COVID-19 pneumonia: a systematic review and meta-analysis. Expert Rev Respir Med. 2022;16(10):1109-32.

Horby P, Lim WS, Emberson J, Mafham M, Bell J, Linsell L, et al. Effect of dexamethasone in hospitalized patients with COVID-19–preliminary report. MedRxiv. 2020:2020.06. 22.20137273.

Mourad A, Thibault D, Holland TL, Yang S, Young AR, Egloff SAA, et al. Dexamethasone for Inpatients With COVID-19 in a National Cohort. JAMA Network Open. 2023;6(4):e238516-e.

Saini M, Rana M, Bhatti K, Das R, Mehta DK, Chidurala RM. Clinical efficacy of Remdesivir and Favipiravir in the treatment of Covid-19 patients: scenario so far. Curr Drug Abuse Rev. 2022;14(1):11-9.

Al-Ardhi FM, Novotny L, Alhunayan A, Al-Tannak NF. Comparison of remdesivir and favipiravir-the anti-Covid-19 agents mimicking purine RNA constituents. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2022;166(1): 12-20.

Bagi HM, Soleimanpour M, Abdollahi F, Soleimanpour H. Evaluation of clinical outcomes of patients with mild symptoms of coronavirus disease 2019 (COVID-19) discharged from the emergency department. PLOS ONE. 2021;16(10):e0258697.

Alunno A, Najm A, Mariette X, De Marco G, Emmel J, Mason L, et al. Immunomodulatory therapies for the treatment of SARS-CoV-2 infection: an update of the systematic literature review to inform EULAR points to consider. RMD open. 2021;7(3):e001899.

Tekantapeh ST, Nader ND, Ghojazadeh M, Fereidouni F, Soleimanpour H. Prone positioning effect on tracheal intubation rate, mortality and oxygenation parameters in awake non-intubated severe COVID-19-induced respiratory failure: a review of reviews. Eur J Med Res. 2024;29(1):63.

Zhang C, Wu Z, Li JW, Zhao H, Wang GQ. Cytokine release syndrome in severe COVID-19: interleukin-6 receptor antagonist tocilizumab may be the key to reduce mortality. Int J Antimicrob Agents. 2020;55(5):105954.

Saha A, Sharma AR, Bhattacharya M, Sharma G, Lee SS, Chakraborty C. Tocilizumab: A Therapeutic Option for the Treatment of Cytokine Storm Syndrome in COVID-19. Arch Med Res. 2020;51(6):595-7.

Kaur S, Bansal Y, Kumar R, Bansal G. A panoramic review of IL-6: Structure, pathophysiological roles and inhibitors. Bioorg Med Chem. 2020;28(5):115327.

Khanna D, Denton CP, Lin CJF, van Laar JM, Frech TM, Anderson ME, et al. Safety and efficacy of subcutaneous tocilizumab in systemic sclerosis: results from the open-label period of a phase II randomised controlled trial (faSScinate). Ann Rheum Dis. 2018;77(2):212-20.

Choy EH, De Benedetti F, Takeuchi T, Hashizume M, John MR, Kishimoto T. Translating IL-6 biology into effective treatments. Nat Rev Rheumatol. 2020;16(6):335-45.

Le RQ, Li L, Yuan W, Shord SS, Nie L, Habtemariam BA, et al. FDA approval summary: tocilizumab for treatment of chimeric antigen receptor T cell‐induced severe or life‐threatening cytokine release syndrome. The oncologist. 2018;23(8):943-7.

Arsh AM, Mishra S, Tripathi V, Mishra A. Cytokine Storm and Immunomodulation in COVID-19: A Review. Coronaviruses. 2022;3(1):25-33.

Sarhan NM, Warda AEA, Ibrahim HSG, Schaalan MF, Fathy SM. Evaluation of infliximab/tocilizumab versus tocilizumab among COVID-19 patients with cytokine storm syndrome. Sci Rep. 2023;13(1):6456.

Sahebnasagh A, Nabavi SM, Kashani HRK, Abdollahian S, Habtemariam S, Rezabakhsh A. Anti-VEGF agents: As appealing targets in the setting of COVID-19 treatment in critically ill patients. Int Immunopharmacol. 2021;101(Pt B):108257.

Kabiri N, Abbasi A, Pashazadeh F, Hajebrahimi S, Soleimanpour H. The Impact of The COVID-19 Pandemic on Hospital Admissions Due to Road Traffic Crashes; a Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2023;12(1):e12.

Tahsini Tekantapeh S, Mikaeili H, Soleimanpour H. The Role of Respiratory System Surface Area and Ventilation Volume in Severity and Mortality of COVID-19 Infection. Front Emerg Med. 2021;5(3):e27 .

Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med. 2020;46(5):854-87.

Di Giambenedetto S, Ciccullo A, Borghetti A, Gambassi G, Landi F, Visconti E, et al. Off-label use of tocilizumab in patients with SARS-CoV-2 infection. J Med Virol. 2020;92(10):1787-8.

Wang X, Rao J, Tan Z, Xun T, Zhao J, Yang X. Inflammatory signaling on cytochrome P450-mediated drug metabolism in hepatocytes. Front Pharmacol. 2022; 24;13:1043836.

Shadvar K, Tagizadiyeh A, Gamari AA, Soleimanpour H, Mahmoodpoor A. Hemoperfusion as a Potential Treatment for Critically Ill COVID-19 Patients with Cytokine Storm. Blood Purif. 2021;50(3):405-7.

Samaee H, Mohsenzadegan M, Ala S, Maroufi SS, Moradimajd P. Tocilizumab for treatment patients with COVID-19: recommended medication for novel disease. Int Immunopharmacol. 2020; 89(Pt A):107018.

Salvarani C, Dolci G, Massari M, Merlo DF, Cavuto S, Savoldi L, et al. Effect of Tocilizumab vs Standard Care on Clinical Worsening in Patients Hospitalized With COVID-19 Pneumonia: A Randomized Clinical Trial. JAMA Internal Medicine. 2021;181(1):24-31.

Chen J-T, Ostermann M. Review of anti-inflammatory and antiviral therapeutics for hospitalized patients infected with severe acute respiratory syndrome coronavirus 2. Crit Care Clin. 2022;38(3):587-600.

Avni T, Leibovici L, Cohen I, Atamna A, Guz D, Paul M, et al. Tocilizumab in the treatment of COVID-19—a meta-analysis. QJM: An International Journal of Medicine. 2021;114(8):577-86.

Piscoya A, Parra Del Riego A, Cerna-Viacava R, Rocco J, Roman YM, Escobedo AA, et al. Efficacy and harms of tocilizumab for the treatment of COVID-19 patients: A systematic review and meta-analysis. PLoS One. 2022;17(6):e0269368.

Kashour T, Tleyjeh IM. Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis – Author's reply. Clin Microbiol Infect. 2021;27(8):1177-8.

Conti V, Corbi G, Sellitto C, Sabbatino F, Maci C, Bertini N, et al. Effect of tocilizumab in reducing the mortality rate in COVID-19 patients: a systematic review with meta-analysis. J Pers Med. 2021;11(7):628.

Snow TAC, Saleem N, Ambler G, Nastouli E, Singer M, Arulkumaran N. Tocilizumab in COVID-19: a meta-analysis, trial sequential analysis, and meta-regression of randomized-controlled trials. Intensive Care Med. 2021;47(6):641-52.

Nugroho CW, Suryantoro SD, Yuliasih Y, Rosyid AN, Asmarawati TP, Andrianto L, et al. Optimal use of tocilizumab for severe and critical COVID-19: a systematic review and meta-analysis. F1000Res. 2021;10:73.

Aziz M, Haghbin H, Abu Sitta E, Nawras Y, Fatima R, Sharma S, et al. Efficacy of tocilizumab in COVID‐19: a systematic review and meta‐analysis. J Med Virol. 2021;93(3):1620-30.

Shankar-Hari M, Vale CL, Godolphin PJ, Fisher D, Higgins JPT, Spiga F, et al. Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19: A Meta-analysis. Jama. 2021;326(6):499-518.

Lan S-H, Lai C-C, Huang H-T, Chang S-P, Lu L-C, Hsueh P-R. Tocilizumab for severe COVID-19: a systematic review and meta-analysis. Int. J. Antimicrob. Agents. 2020;56(3):106103.

Klopfenstein T, Gendrin V, Gerazime A, Conrozier T, Balblanc JC, Royer PY, et al. Systematic Review and Subgroup Meta-analysis of Randomized Trials to Determine Tocilizumab’s Place in COVID-19 Pneumonia. Infect Dis Ther. 2021;10(3):1195-213.

Selvarajan S, Anandaradje A, Shivabasappa S, Melepurakkal Sadanandan D, Nair NS, George M. Efficacy of pharmacological interventions in COVID‐19: a network meta‐analysis. Br J Clin Pharmacol. 2022;88(9):4080-91.

Juul S, Nielsen EE, Feinberg J, Siddiqui F, Jørgensen CK, Barot E, et al. Interventions for treatment of COVID-19: A living systematic review with meta-analyses and trial sequential analyses (The LIVING Project). PLoS med. 2020;17(9):e1003293.

Kyriakopoulos C, Ntritsos G, Gogali A, Milionis C, Evangelou E, Kostikas K. Late Breaking Abstract - Tocilizumab administration for the treatment of hospitalised patients with COVID-19: A systematic review and meta-analysis. Eur Respir J. 2021;58.

Pinzon RT, Wijaya VO, Buana RB. Interleukin-6 (IL-6) inhibitors as therapeutic agents for coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. J Infect Public Health. 2021;14(8):1001-9.

Rezaei S, Fatemi B, Majd ZK, Minaei H, Peikanpour M, Anjidani N, et al. Efficacy and safety of Tocilizumab in severe and critical COVID-19: A Systematic Review and Meta-Analysis. Expert Rev Clin Immunol. 2021;17(5):499-511.

Mahroum N, Watad A, Bridgewood C, Mansour M, Nasr A, Hussein A, et al. Systematic review and meta-analysis of tocilizumab therapy versus standard of care in over 15,000 covid-19 pneumonia patients during the first eight months of the pandemic. Int J Environ Res Public Health. 2021;18(17): 9149.

Klopfenstein T, Gendrin V, Kadiane‐Oussou NdJ, Conrozier T, Zayet S, Team HHTM. Tocilizumab in COVID‐19 pneumonia: Practical proposals based on a narrative review of randomised trials. Revs Medical Virology. 2022;32(1):e2239.

Hashizume M. Outlook of IL-6 signaling blockade for COVID-19 pneumonia. Inflamm Regene. 2020;40:24.

Tleyjeh IM, Kashour Z, Riaz M, Hassett L, Veiga VC, Kashour T. Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis, first update. Clin Microbiol Infect. 2021;27(8):1076-82.

Jiang W, Li W, Wu Q, Han Y, Zhang J, Luo T, et al. Efficacy and safety of tocilizumab treatment COVID-19 patients: A case-control study and meta-analysis. Infect Dis Ther. 2021;10:1677-98.

Rezaei Tolzali MM, Noori M, Shokri P, Rahmani S, Khanzadeh S, Nejadghaderi SA, et al. Efficacy of tocilizumab in the treatment of COVID-19: An umbrella review. Rev Med Virol. 2022; 32(6):e2388.

Farooqi F, Dhawan N, Morgan R, Dinh J, Nedd K, Yatzkan G. Treatment of severe COVID-19 with tocilizumab mitigates cytokine storm and averts mechanical ventilation during acute respiratory distress: a case report and literature review. Trop med infect. 2020;5(3):112.

Chen C-x, Hu F, Wei J, Yuan L-t, Wen T-m, Gale RP, et al. Systematic review and meta-analysis of tocilizumab in persons with coronavirus disease-2019 (COVID-19). Leukemia. 2021;35(6):1661-70.

Kyriakopoulos C, Ntritsos G, Gogali A, Milionis H, Evangelou E, Kostikas K. Tocilizumab administration for the treatment of hospitalized patients with COVID‐19: a systematic review and meta‐analysis. Respirology. 2021;26(11):1027-40.

Chastain DB, Stitt TM, Ly PT, Henao-Martínez AF, Franco-Paredes C, Osae SP, editors. Countermeasures to coronavirus disease 2019: are Immunomodulators rational treatment options—A critical review of the evidence. Open Forum Infect Dis. 2020;7(7):ofaa219.

Albuquerque AM, Tramujas L, Sewanan LR, Williams DR, Brophy JM. Mortality rates among hospitalized patients with COVID-19 infection treated with tocilizumab and corticosteroids: a Bayesian reanalysis of a previous meta-analysis. JAMA Network Open. 2022;5(2):e220548-e.

Marino A, Pampaloni A, Scuderi D, Cosentino F, Moscatt V, Ceccarelli M, et al. High‑flow nasal cannula oxygenation and tocilizumab administration in patients critically ill with COVID‑19: A report of three cases and a literature review. World Acad Sci J. 2020;2(6):23.

Pinzon RT, Wijaya VO, Buana RB. Interleukin-6 (IL-6) inhibitors as therapeutic agents for coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. J Infect Public Health. 2021;14(8):1001-9.

Shahsavarinia K, Ghojazadeh M, Ghabousian A, Hatefnia F, Soleimanpour M, Soleimanpour H. An Umbrella Review of Clinical Efficacy and Adverse Cardiac Events Associated with Hydroxychloroquine or Chloroquine with or Without Azithromycin in Patients with COVID-19. Anesth Pain Med. 2021;11(4):e115827.

Atal S, Fatima Z. IL-6 Inhibitors in the Treatment of Serious COVID-19: A Promising Therapy? Pharmaceut Med. 2020;34(4):223-31.

Sepriano A, Kerschbaumer A, Smolen JS, van der Heijde D, Dougados M, van Vollenhoven R, et al. Safety of synthetic and biological DMARDs: a systematic literature review informing the 2019 update of the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis. 2020;79(6):760-70.

Nhean S, Varela ME, Nguyen Y-N, Juarez A, Huynh T, Udeh D, et al. COVID-19: a review of potential treatments (corticosteroids, remdesivir, tocilizumab, bamlanivimab/etesevimab, and casirivimab/imdevimab) and pharmacological considerations. J Pharm Pract. 2023;36(2):407-17.

Severino N, Gutiérrez W, Fuenzalida T, Iturra P, González A. [Surveillance of adverse effects of Tocilizumab for COVID-19]. Rev. méd. Chile. 2022;150(4):431-8. Tocilizumab en pacientes COVID-19: evaluación del perfil de seguridad en una indicación off label

Chaudhry D, Singh PK. Tocilizumab and COVID-19. Indian J Crit Care Med. 2020;24(9):741-3.

Gatti M, Fusaroli M, Caraceni P, Poluzzi E, De Ponti F, Raschi E. Serious adverse events with tocilizumab: Pharmacovigilance as an aid to prioritize monitoring in COVID-19. Br J Clin Pharmacol. 2021;87(3):1533-40.

Tada A, Hashida N, Tanaka T, Nishida K. Anti-interleukin-6 receptor antibody therapy-induced retinopathy in a patient with rheumatoid arthritis. Case Rep Rheumatol. 2012;2012:270315.

Belletti A, Campochiaro C, Marmiere M, Likhvantsev V, Yavorovskiy A, Dagna L, et al. Efficacy and safety of IL-6 inhibitors in patients with COVID-19 pneumonia: a systematic review and meta-analysis of multicentre, randomized trials. Ann Intensive Care.2021; 11(1):152.

Al Bishawi A, Abdalla S, Askar M, Kanjo W, Sameer A, Mustafa G, et al. Dilemma of Tocilizumab therapy for a patient with critical COVID‐19 disease and neutropenia: Case report and review of the literature. Clin Case Rep. 2022;10(5):e05932.

Merz LE, Story CM, Osei MA, Jolley K, Ren S, Park HS, et al. Absolute neutrophil count by Duffy status among healthy Black and African American adults. Blood Adv. 2023;7(3):317-20.

Bernardo L, Del Sesto S, Giordano L, Benincaso AR, Biondi P, Goj V, et al. Severe prolonged neutropenia following administration of tocilizumab in a patient affected by COVID-19: a case report and brief review of the literature. Drugs Ther Perspect. 2020; 36(12):568-572.

Soubrier M, Pei J, Durand F, Gullestad L, John A. Concomitant Use of Statins in Tocilizumab-Treated Patients with Rheumatoid Arthritis: A Post Hoc Analysis. Rheumatol Ther. 2017;4(1):133-49.

Lazzerini PE, Acampa M, Capecchi PL, Fineschi I, Selvi E, Moscadelli V, et al. Antiarrhythmic potential of anticytokine therapy in rheumatoid arthritis: tocilizumab reduces corrected QT interval by controlling systemic inflammation. Arthritis Care Res (Hoboken). 2015;67(3):332-9.

Plasencia-García BO, Rodríguez-Menéndez G, Rico-Rangel MI, Rubio-García A, Torelló-Iserte J, Crespo-Facorro B. Drug-drug interactions between COVID-19 treatments and antipsychotics drugs: integrated evidence from 4 databases and a systematic review. Psychopharmacology (Berl). 2021;238(2):329-40.

Geier MR, Geier DA. Respiratory conditions in coronavirus disease 2019 (COVID-19): Important considerations regarding novel treatment strategies to reduce mortality. Med Hypotheses. 2020;140:109760.

Banji D, Alqahtani SS, Banji OJF, Machanchery S, Shoaib A. Calming the inflammatory storm in severe COVID-19 infections: Role of biologics- A narrative review. Saudi Pharm J. 2021;29(3):213-22.

Garcia-Vidal C, Sanjuan G, Moreno-García E, Puerta-Alcalde P, Garcia-Pouton N, Chumbita M, et al. Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study. Clin Microbiol Infect. 2021;27(1):83-8.

Fu Y, Yang Q, Xu M, Kong H, Chen H, Fu Y, et al.Secondary bacterial infections in critical ill patients with coronavirus disease 2019. Open Forum Infect Dis. 2020; 7(6):ofaa220.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The lancet. 2020;395(10223):507-13.

Group TWREAfC-TW. Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19: A Meta-analysis. JAMA. 2021;326(6):499-518.

Rubio‐Rivas M, Forero CG, Mora‐Luján JM, Montero A, Formiga F, Homs NA, et al. Beneficial and harmful outcomes of tocilizumab in severe COVID‐19: a systematic review and meta‐analysis. Pharmacotherapy. 2021;41(11):884-906.

Wang Y, Mao Q, Zhou X. Does tocilizumab have a magical therapeutic effect on COVID-19 patients without obvious adverse reactions? Proc Natl Acad Sci. 2020;117(49):30896-7.

Quartuccio L, Sonaglia A, McGonagle D, Fabris M, Peghin M, Pecori D, et al. Profiling COVID-19 pneumonia progressing into the cytokine storm syndrome: results from a single Italian Centre study on tocilizumab versus standard of care. J Clin Virol. 2020;129:104444.

Antinori S, Bonazzetti C, Gubertini G, Capetti A, Pagani C, Morena V, et al. Tocilizumab for cytokine storm syndrome in COVID-19 pneumonia: an increased risk for candidemia? Autoimmun Rev. 2020;19(7):102564.

Peng J, Fu M, Mei H, Zheng H, Liang G, She X, et al. Efficacy and secondary infection risk of tocilizumab, sarilumab and anakinra in COVID-19 patients: A systematic review and meta-analysis. Rev Med Virol. 2022;32(3):e2295.

Hariyanto TI, Hardyson W, Kurniawan A. Efficacy and safety of tocilizumab for coronavirus disease 2019 (Covid-19) patients: a systematic review and meta-analysis. Drug Res. 2021;71(05):265-74.

Jain S, Potschka H, Chandra PP, Tripathi M, Vohora D. Management of COVID-19 in patients with seizures: Mechanisms of action of potential COVID-19 drug treatments and consideration for potential drug-drug interactions with anti-seizure medications. Epilepsy Res. 2021;174:106675.

Moosazadeh M, Mousavi T. Combination therapy of tocilizumab and steroid for COVID-19 patients: A meta-analysis. J Med Virol. 2022;94(4):1350-6.

Kim MS, An MH, Kim WJ, Hwang TH. Comparative efficacy and safety of pharmacological interventions for the treatment of COVID-19: A systematic review and network meta-analysis. PLoS Med. 2020;17(12):e1003501.

Lim PC, Wong KL, Rajah R, Chong MF, Chow TS, Subramaniam S, et al. Comparing the efficacy of tocilizumab with corticosteroid therapy in treating COVID-19 patients: a systematic review and meta-analysis. Daru. 2022;30(1):211-28.

Zeraatkar D, Cusano E, Martínez JPD, Qasim A, Mangala S, Kum E, et al. Use of tocilizumab and sarilumab alone or in combination with corticosteroids for covid-19: systematic review and network meta-analysis. BMJ Medicine. 2022;1(1):e000036.

Alunno A, Najm A, Machado PM, Bertheussen H, Burmester G-RR, Carubbi F, et al. 2021 update of the EULAR points to consider on the use of immunomodulatory therapies in COVID-19. Ann Rheum Dis. 2022;81(1):34-40.

Alkofide H, Almohaizeie A, Almuhaini S, Alotaibi B, Alkharfy KM. Tocilizumab and systemic corticosteroids in the management of patients with COVID-19: a systematic review and meta-analysis. Int J Infect Dis J. 2021;110:320-9.

Grygiel-Górniak B, Shaikh O, Kumar NN, Hsu SH, Samborski W. Use of the rheumatic drug tocilizumab for treatment of SARS-CoV-2 patients. Reumatologia/Rheumatology. 2021;59(4):252-9.

Yousef MS, Idris NS, Yap C, Alsubaie AA, Kakodkar P. Systematic review on the clinical presentation and management of the COVID-19 associated multisystem inflammatory syndrome in children (MIS-C). AIMS Allergy Immunol. 2021;5(1):38-55.

Shetty VU, Brotherton BJ, Achilleos A, Akrami KM, Barros LM, Checkley W, et al. Pragmatic Recommendations for Therapeutics of Hospitalized COVID-19 Patients in Low- and Middle-Income Countries. Am J Trop Med Hyg. 2020;104(3_Suppl):48-59.

Jorgensen SC, Tabbara N, Burry L. A review of COVID-19 therapeutics in pregnancy and lactation. Obstet Med. 2022;15(4):225-32.

Hoeltzenbein M, Beck E, Rajwanshi R, Skorpen CG, Berber E, Schaefer C, et al. Tocilizumab use in pregnancy: analysis of a global safety database including data from clinical trials and post-marketing data. Semin Arthritis Rheum. 2016: 46(2):238-245.

Skorpen CG, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016;75(5):795-810.

Stewart J. Developmental toxicity testing of monoclonal antibodies: an enhanced pre-and postnatal study design option. Reprod Toxicol. 2009;28(2):220-5.

Weber-Schoendorfer C, Schaefer C. Pregnancy outcome after tocilizumab therapy in early pregnancy-a case series from the German Embryotox Pharmacovigilance Center. Reprod Toxicol. 2016;60:29-32.

Jorgensen SC, Lapinsky SE. Tocilizumab for coronavirus disease 2019 in pregnancy and lactation: a narrative review. Clin Microbiol Infect. 2022;28(1):51-7.

Jiménez-Lozano I, Caro-Teller JM, Fernández-Hidalgo N, Miarons M, Frick MA, Batllori Badia E, et al. Safety of tocilizumab in COVID-19 pregnant women and their newborn: A retrospective study. J Clin Pharm Ther. 2021;46(4):1062-70.

Akinosoglou K, Schinas G, Rigopoulos E-A, Polyzou E, Tzouvelekis A, Adonakis G, et al. COVID-19 Pharmacotherapy in Pregnancy: A Literature Review of Current Therapeutic Choices. Viruses. 2023;15(3):787.

Zhang J, Chen C, Yang Y, Yang J. Effectiveness of tocilizumab in the treatment of hospitalized adults COVID-19: A systematic review and meta-analysis. Medicine (Baltimore). 2022;101(9):e28967.

Mutua V, Henry BM, Csefalvay CV, Cheruiyot I, Vikse J, Lippi G, et al. Tocilizumab in addition to standard of care in the management of COVID-19: a meta-analysis of RCTs. Acta Biomed. 2022;93(1):e2022014.

Comments (0)

No login
gif