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
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
Current version onlyTociliuzumab compared to standard care/placebo for mild/moderate/severe/critical COVID‐19
Population: people with mild/moderate/severe/critical COVID‐19
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical improvement D28b Tociliuzumab vs standard care/placebo | RR 1.05 [1, 1.11] | 15 studies · 6116 participants | Moderate 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 participants | Very 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 participants | Low Downgraded: risk of bias, imprecision |
All‐cause mortality D28 Tociliuzumab vs standard care/placebo | RR 0.88 [0.81, 0.94] | 18 studies · 7428 participants | High |
All‐cause mortality D60 or more Tociliuzumab vs standard care/placebo | RR 0.91 [0.8, 1.04] | 9 studies · 2775 participants | Low Downgraded: risk of bias, imprecision |
Adverse events ( Tociliuzumab vs standard care/placebo | RR 1.03 [0.95, 1.12] | 9 studies · 1811 participants | Moderate Downgraded: imprecision |
Serious adverse events ( Tociliuzumab vs standard care/placebo | RR 0.93 [0.81, 1.07] | 16 studies · 2974 participants | Very 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical improvement D28b Sarilumab vs standard care/placebo | RR 0.99 [0.94, 1.05] | 7 studies · 2425 participants | Moderate Downgraded: risk of bias |
Clinical improvement D60 or moree Sarilumab vs standard care/placebo | RR 1.22 [0.91, 1.63] | 2 studies · 239 participants | Very 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 participants | Very 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 participants | Very 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 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events ( Sarilumab vs standard care/placebo | RR 1.12 [0.97, 1.28] | 4 studies · 860 participants | Low Downgraded: risk of bias, imprecision |
Serious adverse events ( Sarilumab vs standard care/placebo | RR 1.09 [0.97, 1.21] | 6 studies · 2936 participants | Low 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical improvement D28b Clazakizumab vs standard care/placebo | RR 1.28 [0.97, 1.7] | 1 study · 152 participants | Very low Downgraded: imprecision, indirectness |
Clinical improvement D60 or more Clazakizumab vs standard care/placebo | RR 1.28 [0.99, 1.66] | 1 study · 152 participants | Very 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 participants | Very low Downgraded: imprecision, indirectness |
All‐cause mortality D28 Clazakizumab vs standard care/placebo | RR 0.91 [0.54, 1.55] | 2 studies · 169 participants | Very 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 participants | Very low Downgraded: imprecision, indirectness |
Adverse events ( Clazakizumab vs standard care/placebo | RR 1.12 [0.2, 6.24] | 1 study · 17 participants | Low Downgraded: imprecision, indirectness |
Serious adverse events ( Clazakizumab vs standard care/placebo | RR 0.69 [0.46, 1.04] | 2 studies · 169 participants | Low 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical improvement D28b Olokizumab vs standard care/placebo | RR 1.1 [0.96, 1.24] | 1 study · 248 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Clinical improvement D60 or more ‐ not reported Olokizumab vs standard care/placebo | no estimate extracted | NR | No studies |
WHO progression score (level 7 or above) D28 ‐ not reported Olokizumab vs standard care/placebo | no estimate extracted | NR | No studies |
All‐cause mortality D28 Olokizumab vs standard care/placebo | RR 1.5 [0.55, 4.09] | 1 study · 248 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
All‐cause mortality D60 or more ‐ not reported Olokizumab vs standard care/placebo | no estimate extracted | NR | No studies |
Adverse events ‐ not reported Olokizumab vs standard care/placebo | no estimate extracted | NR | No studies |
Serious adverse events ( Olokizumab vs standard care/placebo | RR 1.25 [0.51, 3.06] | 1 study · 248 participants | Very 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical improvement D28b Siltuximab vs standard care/placebo | RR 0.97 [0.79, 1.18] | 1 study · 148 participants | Very low Downgraded: imprecision, indirectness |
Clinical improvement D60 or more ‐ not reported Siltuximab vs standard care/placebo | no estimate extracted | NR | No studies |
WHO progression score (level 7 or above) D28 Siltuximab vs standard care/placebo | RR 1.97 [1.07, 3.63] | 1 study · 148 participants | Low Downgraded: imprecision, indirectness |
All‐cause mortality D28 Siltuximab vs standard care/placebo | RR 1.35 [0.54, 3.36] | 1 study · 148 participants | Very 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 participants | Very low Downgraded: imprecision, indirectness |
Adverse events ‐ not reported Siltuximab vs standard care/placebo | no estimate extracted | NR | No studies |
Serious adverse events ( Siltuximab vs standard care/placebo | RR 1.29 [0.64, 2.62] | 1 study · 148 participants | Low 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical improvement D28b Levilimab vs standard care/placebo | RR 1.53 [1.26, 1.85] | 1 study · 206 participants | Low Downgraded: imprecision, indirectness |
Clinical improvement D60 or more ‐ not reported Levilimab vs standard care/placebo | no estimate extracted | NR | No studies |
WHO progression score (level 7 or above) D28 ‐ not reported Levilimab vs standard care/placebo | no estimate extracted | NR | No studies |
All‐cause mortality D28 Levilimab vs standard care/placebo | RR 1 [0.26, 3.89] | 1 study · 206 participants | Very low Downgraded: imprecision, indirectness |
All‐cause mortality D60 or more Levilimab vs standard care/placebo | RR 1 [0.26, 3.89] | 1 study · 206 participants | Very low Downgraded: imprecision, indirectness |
Adverse events ( Levilimab vs standard care/placebo | RR 1.17 [0.73, 1.87] | 1 study · 206 participants | Low Downgraded: imprecision, indirectness |
Serious adverse events ( Levilimab vs standard care/placebo | RR 0.5 [0.05, 5.43] | 1 study · 206 participants | Low Downgraded: imprecision, indirectness |
Tociliuzumab compared to standard care/placebo for mild/moderate/severe/critical COVID‐19
Population: participants with mild/moderate/severe/critical COVID‐19
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical improvement D28 Tociliuzumab vs standard care/placebo | RR 1.06 [1, 1.13] | 7 studies · 5585 participants | Moderate Downgraded: risk of bias |
WHO progression score (level 7 or above) D28 Tociliuzumab vs standard care/placebo | RR 0.99 [0.56, 1.74] | 3 studies · 712 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
All‐cause mortality D28 Tociliuzumab vs standard care/placebo | RR 0.89 [0.82, 0.97] | 8 studies · 6363 participants | High |
All‐cause mortality D60 Tociliuzumab vs standard care/placebo | RR 0.86 [0.53, 1.4] | 2 studies · 519 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events Tociliuzumab vs standard care/placebo | RR 1.23 [0.87, 1.72] | 7 studies · 1534 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Serious adverse events Tociliuzumab vs standard care/placebo | RR 0.89 [0.75, 1.06] | 8 studies · 2312 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Time to clinical improvement 28 to 90 days Tociliuzumab vs standard care/placebo | HR 1.23 [1.08, 1.39] | 6 studies · 2118 participants | Moderate Downgraded: risk of bias |
Time to WHO progression score (level 7 and above) Tociliuzumab vs standard care/placebo | HR 0.62 [0.42, 0.91] | 3 studies · 762 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Time to death Tociliuzumab vs standard care/placebo | HR 0.65 [0.51, 0.83] | 3 studies · 1152 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Sarilumab compared to standard care for severe/critical COVID‐19
Population: participants with severe/critical COVID‐19
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical improvement D28 Sarilumab vs standard care | no estimate extracted | NR | No studies |
WHO progression score (level 7 or above) D28 Sarilumab vs standard care | no estimate extracted | NR | No studies |
All‐cause mortality D28 Sarilumab vs standard care | RR 0.77 [0.43, 1.36] | 2 studies · 880 participants | Low Downgraded: risk of bias |
All‐cause mortality D60 or above Sarilumab vs standard care | RR 1 [0.5, 2] | 1 study · 420 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Sarilumab vs standard care | RR 1.05 [0.88, 1.25] | 1 study · 420 participants | Moderate Downgraded: risk of bias, imprecision, indirectness |
Serious adverse events Sarilumab vs standard care | RR 1.17 [0.77, 1.77] | 2 studies · 880 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Time to clinical improvement Sarilumab vs standard care | HR 1.28 [0.88, 1.87] | 2 studies · 880 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Time to WHO progression score (level 7 and above) Sarilumab vs standard care | no estimate extracted | NR | No studies |
Time to death Sarilumab vs standard care | HR 0.55 [0.33, 0.91] | 1 study · 460 participants | Low Downgraded: risk of bias |