Cochrane · systematic review · CD013881

Interleukin‐6 blocking agents for treating COVID‐19: a living systematic review

Ghosn, L, Assi, R, Evrenoglou, T, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library

Emergency and Critical Care2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
42
current version
GRADE rated
34
No studies
8
Included studies
NR
No studies 8 · 19%Ungraded 0 · 0%Very low 19 · 45.2%Low 11 · 26.2%Moderate 3 · 7.1%High 1 · 2.4%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Tociliuzumab compared to standard care/placebo for mild/moderate/severe/critical COVID‐19

Population: people with mild/moderate/severe/critical COVID‐19
7 questions
OutcomeEffectEvidenceStatus / GRADE
Clinical improvement D28b
Tociliuzumab vs standard care/placebo
RR 1.05 [1, 1.11]15 studies · 6116 participantsModerate
Downgraded: risk of bias, imprecision
Clinical improvement D60 or moref
Tociliuzumab vs standard care/placebo
RR 1.1 [0.81, 1.48]1 study · 97 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
WHO progression score (level 7 or above) D28
Tociliuzumab vs standard care/placebo
RR 0.9 [0.72, 1.12]13 studies · 2117 participantsLow
Downgraded: risk of bias, imprecision
All‐cause mortality D28
Tociliuzumab vs standard care/placebo
RR 0.88 [0.81, 0.94]18 studies · 7428 participantsHigh
All‐cause mortality D60 or more
Tociliuzumab vs standard care/placebo
RR 0.91 [0.8, 1.04]9 studies · 2775 participantsLow
Downgraded: risk of bias, imprecision
Adverse events (
Tociliuzumab vs standard care/placebo
RR 1.03 [0.95, 1.12]9 studies · 1811 participantsModerate
Downgraded: imprecision
Serious adverse events (
Tociliuzumab vs standard care/placebo
RR 0.93 [0.81, 1.07]16 studies · 2974 participantsVery low
Downgraded: risk of bias, imprecision

Sarilumab compared to standard care/placebo for mild/moderate/severe/critical COVID‐19

Population: people with mild/moderate/severe/critical COVID‐19
7 questions
OutcomeEffectEvidenceStatus / GRADE
Clinical improvement D28b
Sarilumab vs standard care/placebo
RR 0.99 [0.94, 1.05]7 studies · 2425 participantsModerate
Downgraded: risk of bias
Clinical improvement D60 or moree
Sarilumab vs standard care/placebo
RR 1.22 [0.91, 1.63]2 studies · 239 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency, indirectness
WHO progression score (level 7 or above) D28
Sarilumab vs standard care/placebo
RR 1.1 [0.9, 1.33]5 studies · 886 participantsVery low
Downgraded: risk of bias, imprecision
All‐cause mortality D28
Sarilumab vs standard care/placebo
RR 1.06 [0.86, 1.3]9 studies · 3305 participantsVery low
Downgraded: risk of bias, imprecision
All‐cause mortality D60 or more
Sarilumab vs standard care/placebo
RR 0.95 [0.84, 1.07]6 studies · 3379 participantsVery low
Downgraded: risk of bias, imprecision
Adverse events (
Sarilumab vs standard care/placebo
RR 1.12 [0.97, 1.28]4 studies · 860 participantsLow
Downgraded: risk of bias, imprecision
Serious adverse events (
Sarilumab vs standard care/placebo
RR 1.09 [0.97, 1.21]6 studies · 2936 participantsLow
Downgraded: risk of bias, imprecision

Clazakizumab compared to standard care/placebo for mild/moderate/severe/critical COVID‐19

Population: people with mild/moderate/severe/critical COVID‐19
7 questions
OutcomeEffectEvidenceStatus / GRADE
Clinical improvement D28b
Clazakizumab vs standard care/placebo
RR 1.28 [0.97, 1.7]1 study · 152 participantsVery low
Downgraded: imprecision, indirectness
Clinical improvement D60 or more
Clazakizumab vs standard care/placebo
RR 1.28 [0.99, 1.66]1 study · 152 participantsVery low
Downgraded: imprecision, indirectness
WHO progression score (level 7 or above) D28
Clazakizumab vs standard care/placebo
RR 0.66 [0.43, 1.01]1 study · 152 participantsVery low
Downgraded: imprecision, indirectness
All‐cause mortality D28
Clazakizumab vs standard care/placebo
RR 0.91 [0.54, 1.55]2 studies · 169 participantsVery low
Downgraded: imprecision, indirectness
All‐cause mortality D60 or more
Clazakizumab vs standard care/placebo
RR 0.77 [0.49, 1.19]2 studies · 169 participantsVery low
Downgraded: imprecision, indirectness
Adverse events (
Clazakizumab vs standard care/placebo
RR 1.12 [0.2, 6.24]1 study · 17 participantsLow
Downgraded: imprecision, indirectness
Serious adverse events (
Clazakizumab vs standard care/placebo
RR 0.69 [0.46, 1.04]2 studies · 169 participantsLow
Downgraded: imprecision, indirectness

Olokizumab compared to standard care/placebo for mild/moderate/severe/critical COVID‐19

Population: people with mild/moderate/severe/critical COVID‐19
7 questions
OutcomeEffectEvidenceStatus / GRADE
Clinical improvement D28b
Olokizumab vs standard care/placebo
RR 1.1 [0.96, 1.24]1 study · 248 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Clinical improvement D60 or more ‐ not reported
Olokizumab vs standard care/placebo
no estimate extractedNRNo studies
WHO progression score (level 7 or above) D28 ‐ not reported
Olokizumab vs standard care/placebo
no estimate extractedNRNo studies
All‐cause mortality D28
Olokizumab vs standard care/placebo
RR 1.5 [0.55, 4.09]1 study · 248 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
All‐cause mortality D60 or more ‐ not reported
Olokizumab vs standard care/placebo
no estimate extractedNRNo studies
Adverse events ‐ not reported
Olokizumab vs standard care/placebo
no estimate extractedNRNo studies
Serious adverse events (
Olokizumab vs standard care/placebo
RR 1.25 [0.51, 3.06]1 study · 248 participantsVery low
Downgraded: risk of bias, imprecision, indirectness

Siltuximab compared to standard care/placebo for mild/moderate/severe/critical COVID‐19

Population: people with mild/moderate/severe/critical COVID‐19
7 questions
OutcomeEffectEvidenceStatus / GRADE
Clinical improvement D28b
Siltuximab vs standard care/placebo
RR 0.97 [0.79, 1.18]1 study · 148 participantsVery low
Downgraded: imprecision, indirectness
Clinical improvement D60 or more ‐ not reported
Siltuximab vs standard care/placebo
no estimate extractedNRNo studies
WHO progression score (level 7 or above) D28
Siltuximab vs standard care/placebo
RR 1.97 [1.07, 3.63]1 study · 148 participantsLow
Downgraded: imprecision, indirectness
All‐cause mortality D28
Siltuximab vs standard care/placebo
RR 1.35 [0.54, 3.36]1 study · 148 participantsVery low
Downgraded: imprecision, indirectness
All‐cause mortality D60 or more
Siltuximab vs standard care/placebo
RR 1.58 [0.74, 3.38]1 study · 148 participantsVery low
Downgraded: imprecision, indirectness
Adverse events ‐ not reported
Siltuximab vs standard care/placebo
no estimate extractedNRNo studies
Serious adverse events (
Siltuximab vs standard care/placebo
RR 1.29 [0.64, 2.62]1 study · 148 participantsLow
Downgraded: imprecision, indirectness

Levilimab compared to standard care/placebo for mild/moderate/severe/critical COVID‐19

Population: people with mild/moderate/severe/critical COVID‐19
7 questions
OutcomeEffectEvidenceStatus / GRADE
Clinical improvement D28b
Levilimab vs standard care/placebo
RR 1.53 [1.26, 1.85]1 study · 206 participantsLow
Downgraded: imprecision, indirectness
Clinical improvement D60 or more ‐ not reported
Levilimab vs standard care/placebo
no estimate extractedNRNo studies
WHO progression score (level 7 or above) D28 ‐ not reported
Levilimab vs standard care/placebo
no estimate extractedNRNo studies
All‐cause mortality D28
Levilimab vs standard care/placebo
RR 1 [0.26, 3.89]1 study · 206 participantsVery low
Downgraded: imprecision, indirectness
All‐cause mortality D60 or more
Levilimab vs standard care/placebo
RR 1 [0.26, 3.89]1 study · 206 participantsVery low
Downgraded: imprecision, indirectness
Adverse events (
Levilimab vs standard care/placebo
RR 1.17 [0.73, 1.87]1 study · 206 participantsLow
Downgraded: imprecision, indirectness
Serious adverse events (
Levilimab vs standard care/placebo
RR 0.5 [0.05, 5.43]1 study · 206 participantsLow
Downgraded: imprecision, indirectness