International Journal of Infectious Diseases and Therapy

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The Effect of Tocilizumab in the Treatment of COVID-19 Patients: A Propensity Score-Matched and a Stabilized Inverted Probability of Treatment Weight Study (SIPTW)

Received: 28 September 2021    Accepted: 22 October 2021    Published: 30 October 2021
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Abstract

Studies disputed the use of tocilizumab in the treatment of COVID-19 patients, retrospective studies and one interventional study from the RECOVER study supported tocilizumab use, however, many other interventional and a retrospective propensity score-matched studies did not find a benefit from its use, in contrast, increased mortality was demonstrated, this study aims to add knowledge on this topic. Records for 1124 COVID-19 admitted patients were reviewed. Patients were recruited from three participating hospitals. Characteristics of all-cohort and propensity score-adjusted (PS-adjusted) patients were described, data was analyzed as propensity score matching (PSM) and a stabilized inverted probability of treatment weighting (SIPTW). Management of patients was up to the treating physicians who varied in the treatment approach., the effect difference was estimated by χ2. Further, the study was analyzed as logistic regression to assure robustness of the inferred outcomes; recovery, need for home oxygen, and all-cause mortality. All-cause mortality for patients was 12.7% (143) and in ICU was 54.0% (128). In the all-cohort, there was an increase of patients’ recovery in controls; 39.6% versus tocilizumab 9.9% (P<0.000). The need for home oxygen was more in tocilizumab; 59.2%, controls 38.6% (P<0.000). Mortality was higher in tocilizumab than the controls (25.4% versus 10.9%, P<0.000). Analyses as PSM-adjustment and SIPTW continued to demonstrate significantly less recovery and more mortality with using tocilizumab (P ≤ 0.002), but tocilizumab and the control did not differ significantly for the need for home oxygen therapy (49.1% vs. 48.6% respectively, P=0.945). No benefit was seen for tocilizumab in the treatment of COVID-19 patients, quite the opposite, it showed no recovery benefit, increased mortality, and did not impact the need for home oxygen.

DOI 10.11648/j.ijidt.20210604.14
Published in International Journal of Infectious Diseases and Therapy (Volume 6, Issue 4, December 2021)
Page(s) 146-152
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Tocilizumab, COVID-19 Recovery, COVID-19 and Home Oxygen, COVID-19 Mortality

References
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Author Information
  • Department of Medicine, School of Medicine, University of Jordan, Amman, Jordan

  • Clinical Pharmacy, Al Khalidi Hospital, Amman, Jordan

  • Clinical Pharmacy, Al Khalidi Hospital, Amman, Jordan

  • Department of Medicine, Al Khalidi Hospital, Amman, Jordan

  • Clinical Pharmacy, Al Khalidi Hospital, Amman, Jordan

  • Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan

  • Department of Internal Medicine, Specialty Hospital, Amman, Jordan

  • Department of Internal Medicine, Specialty Hospital, Amman, Jordan

  • Department of Anesthesia, Specialty Hospital, Amman, Jordan

  • Department of Pharmacy, Jordan Hospital, Amman, Jordan

  • Department of Pharmacy, Specialty Hospital, Amman, Jordan

  • Department of Internal Medicine, Specialty Hospital, Amman, Jordan

  • Department of Internal Medicine, Specialty Hospital, Amman, Jordan

  • Nursing Department, Specialty Hospital, Amman, Jordan

Cite This Article
  • APA Style

    Jamal Wadi Al Ramahi, Amal Matar, Nour Hasan, Ma'en Maher Al-Ali, Lara Abdulhadi, et al. (2021). The Effect of Tocilizumab in the Treatment of COVID-19 Patients: A Propensity Score-Matched and a Stabilized Inverted Probability of Treatment Weight Study (SIPTW). International Journal of Infectious Diseases and Therapy, 6(4), 146-152. https://doi.org/10.11648/j.ijidt.20210604.14

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    ACS Style

    Jamal Wadi Al Ramahi; Amal Matar; Nour Hasan; Ma'en Maher Al-Ali; Lara Abdulhadi, et al. The Effect of Tocilizumab in the Treatment of COVID-19 Patients: A Propensity Score-Matched and a Stabilized Inverted Probability of Treatment Weight Study (SIPTW). Int. J. Infect. Dis. Ther. 2021, 6(4), 146-152. doi: 10.11648/j.ijidt.20210604.14

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    AMA Style

    Jamal Wadi Al Ramahi, Amal Matar, Nour Hasan, Ma'en Maher Al-Ali, Lara Abdulhadi, et al. The Effect of Tocilizumab in the Treatment of COVID-19 Patients: A Propensity Score-Matched and a Stabilized Inverted Probability of Treatment Weight Study (SIPTW). Int J Infect Dis Ther. 2021;6(4):146-152. doi: 10.11648/j.ijidt.20210604.14

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  • @article{10.11648/j.ijidt.20210604.14,
      author = {Jamal Wadi Al Ramahi and Amal Matar and Nour Hasan and Ma'en Maher Al-Ali and Lara Abdulhadi and Dania Abu Kaf and Waseem Saadeh and Nour Hamdan and Mohamed Gharaibeh and Hanadi Hamadallah and Ala'a Bader and Mohammad Atout and Sae’ed Moh Mar’I and Tamer Alhamed},
      title = {The Effect of Tocilizumab in the Treatment of COVID-19 Patients: A Propensity Score-Matched and a Stabilized Inverted Probability of Treatment Weight Study (SIPTW)},
      journal = {International Journal of Infectious Diseases and Therapy},
      volume = {6},
      number = {4},
      pages = {146-152},
      doi = {10.11648/j.ijidt.20210604.14},
      url = {https://doi.org/10.11648/j.ijidt.20210604.14},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijidt.20210604.14},
      abstract = {Studies disputed the use of tocilizumab in the treatment of COVID-19 patients, retrospective studies and one interventional study from the RECOVER study supported tocilizumab use, however, many other interventional and a retrospective propensity score-matched studies did not find a benefit from its use, in contrast, increased mortality was demonstrated, this study aims to add knowledge on this topic. Records for 1124 COVID-19 admitted patients were reviewed. Patients were recruited from three participating hospitals. Characteristics of all-cohort and propensity score-adjusted (PS-adjusted) patients were described, data was analyzed as propensity score matching (PSM) and a stabilized inverted probability of treatment weighting (SIPTW). Management of patients was up to the treating physicians who varied in the treatment approach., the effect difference was estimated by χ2. Further, the study was analyzed as logistic regression to assure robustness of the inferred outcomes; recovery, need for home oxygen, and all-cause mortality. All-cause mortality for patients was 12.7% (143) and in ICU was 54.0% (128). In the all-cohort, there was an increase of patients’ recovery in controls; 39.6% versus tocilizumab 9.9% (P<0.000). The need for home oxygen was more in tocilizumab; 59.2%, controls 38.6% (P<0.000). Mortality was higher in tocilizumab than the controls (25.4% versus 10.9%, P<0.000). Analyses as PSM-adjustment and SIPTW continued to demonstrate significantly less recovery and more mortality with using tocilizumab (P ≤ 0.002), but tocilizumab and the control did not differ significantly for the need for home oxygen therapy (49.1% vs. 48.6% respectively, P=0.945). No benefit was seen for tocilizumab in the treatment of COVID-19 patients, quite the opposite, it showed no recovery benefit, increased mortality, and did not impact the need for home oxygen.},
     year = {2021}
    }
    

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    AU  - Jamal Wadi Al Ramahi
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    AU  - Waseem Saadeh
    AU  - Nour Hamdan
    AU  - Mohamed Gharaibeh
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    JF  - International Journal of Infectious Diseases and Therapy
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    VL  - 6
    IS  - 4
    ER  - 

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