dc.contributor.author | Akleylek, C. | |
dc.contributor.author | Gür, S.G. | |
dc.contributor.author | Sever, İH. | |
dc.contributor.author | Koçulu Demir, S. | |
dc.contributor.author | Çevik, E. | |
dc.contributor.author | Eken, E. | |
dc.contributor.author | Yılmaz, N. | |
dc.date.accessioned | 2022-11-04T19:55:50Z | |
dc.date.available | 2022-11-04T19:55:50Z | |
dc.date.issued | 2022 | |
dc.identifier.issn | 1305-3612 | |
dc.identifier.uri | https://doi.org/10.5152/eurjrheum.2022.21010 | |
dc.identifier.uri | http://hdl.handle.net/11446/4640 | |
dc.description.abstract | OBJECTIVE: Recommendations for the treatment of cytokine release syndrome/macrophage activation syndrome (MAS) associated with coronavirus disease-2019 (COVID-19) are still of poor quality. IL-6 is an important therapeutic target as a main mediator of cytokine storm. The aim of our study was to evaluate the tocilizumab (TCZ) efficacy and factors affecting the therapy outcome. METHODS: This retrospective study included 27 patients treated with TCZ for COVID-19-MAS. All patients in this study were treated with TCZ (intravenously, at a dose of 8 mg kg1 ) in addition to standard therapy. Clinical improvement (survival and decreased oxygen demand) on the 10-14th days and secondary infection rate were assessed. RESULTS: In our 27 treated patients, 14 (51.8%) received TCZ in the intensive care unit (ICU) and seven (25.9%) were need to invasive mechanical ventilation (IMV). Fifteen (55.6%) of these patients revealed a good clinical response (four patients discharge from the ICU and 11 patients who followed-up in nonICU beds showed a decrease in oxygen demand). TCZ was significantly less effective in patients having high Murray lung injury score, low PO2/FiO2 ratio, IMV, and ICU admission (P < .05). Severity of hypoxemia was found as a single independent risk factor in the multivariable analysis (P < .05). Secondary bacterial infections rate was significantly higher in intubated patients (P < .01) or treated in the ICU (P ¼ .01). CONCLUSION: TCZ was showed limited efficacy for COVID-19-related MAS. The most important predictive indicator for therapy outcome was found as the severity of hypoxemia. In addition, IMV and/or ICU was associated with the poor outcome and high side effect. So, controlled trials are still needed to confirm the indications and timing of TCZ therapy. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | NLM (Medline) | en_US |
dc.relation.ispartof | Diagnostic and interventional radiology (Ankara, Turkey) | en_US |
dc.identifier.doi | 10.5152/eurjrheum.2022.21010 | en_US |
dc.rights | info:eu-repo/semantics/openAccess | en_US |
dc.subject | monoclonal antibody | en_US |
dc.subject | oxygen | en_US |
dc.subject | tocilizumab | en_US |
dc.subject | cytokine release syndrome | en_US |
dc.subject | human | en_US |
dc.subject | hypoxia | en_US |
dc.subject | retrospective study | en_US |
dc.subject | Antibodies, Monoclonal, Humanized | en_US |
dc.subject | COVID-19 | en_US |
dc.subject | Cytokine Release Syndrome | en_US |
dc.subject | Humans | en_US |
dc.subject | Hypoxia | en_US |
dc.subject | Oxygen | en_US |
dc.subject | Retrospective Studies | en_US |
dc.subject | SARS-CoV-2 | en_US |
dc.title | What are the main factors affecting the outcome of tocilizumab therapy in COVID-19-induced cytokine release syndrome? | en_US |
dc.type | article | en_US |
dc.identifier.issue | 3 | en_US |
dc.identifier.volume | 9 | en_US |
dc.identifier.startpage | 126 | en_US |
dc.identifier.endpage | 131 | en_US |
dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı | en_US |
dc.department-temp | Akleylek, C., Department of Rheumatology, Demiroglu Bilim University School of MedicineIstanbul, Turkey; Gür, S.G., Department of Radiology, Demiroglu Bilim University School of MedicineIstanbul, Turkey; Sever, İH., Department of Radiology, Demiroglu Bilim University School of MedicineIstanbul, Turkey; Koçulu Demir, S., Department of Infectious Diseases, Demiroglu Bilim University School of MedicineIstanbul, Turkey; Çevik, E., Department of Infectious Diseases, Istanbul Florence Nightingale HospitalIstanbul, Turkey; Eken, E., Department of Anesthesiology, Demiroglu Bilim University School of MedicineIstanbul, Turkey; Gökkaya, Z., Department of Anesthesiology, Demiroglu Bilim University School of MedicineIstanbul, Turkey; Çağatay, Y., Department of Rheumatology, İstanbul Bilim University School of Medicineİstanbul, Turkey; Yılmaz, N., Department of Rheumatology, Demiroglu Bilim University School of MedicineIstanbul, Turkey | en_US |
dc.identifier.pmid | 35156638 | en_US |
dc.identifier.scopus | 2-s2.0-85131401997 | en_US |
dc.authorscopusid | 57210376053 | |
dc.authorscopusid | 57805088800 | |
dc.authorscopusid | 57299310900 | |
dc.authorscopusid | 57846138500 | |
dc.authorscopusid | 57192234397 | |
dc.authorscopusid | 57846801100 | |
dc.authorscopusid | 57191886125 | |