dc.contributor.author | Akleylek, Cansu | |
dc.contributor.author | Gur, Seray Gizem | |
dc.contributor.author | Sever, Ibrahim Halil | |
dc.contributor.author | Demir, Safiye Koculu | |
dc.contributor.author | Cevik, Esin | |
dc.contributor.author | Eken, Egemen | |
dc.contributor.author | Gokkaya, Zafer | |
dc.date.accessioned | 2024-02-04T13:29:34Z | |
dc.date.available | 2024-02-04T13:29:34Z | |
dc.date.issued | 2022 | |
dc.identifier.issn | 2147-9720 | |
dc.identifier.issn | 2148-4279 | |
dc.identifier.uri | https://doi.org/10.5152/eurjrheum.2022.21010 | |
dc.identifier.uri | https://search.trdizin.gov.tr/yayin/detay/1122354 | |
dc.identifier.uri | http://hdl.handle.net/11446/4684 | |
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 kg(-1)) 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 non-ICU beds showed a decrease in oxygen demand). TCZ was significantly less effective in patients having high Murray lung injury score, low PO2/FiO(2) 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 =.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 | Aves | en_US |
dc.relation.ispartof | European Journal Of Rheumatology | en_US |
dc.identifier.doi | 10.5152/eurjrheum.2022.21010 | |
dc.rights | info:eu-repo/semantics/openAccess | en_US |
dc.subject | COVID-19 | en_US |
dc.subject | macrophage activation syndrome | en_US |
dc.subject | interleukin-6 | en_US |
dc.subject | tocilizumab | en_US |
dc.subject | cytokine release syndrome | 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.department | DBÜ | 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, Cansu; Yilmaz, Neslihan] Demiroglu Bilim Univ, Sch Med, Dept Rheumatol, Istanbul, Turkey; [Gur, Seray Gizem; Sever, Ibrahim Halil] Demiroglu Bilim Univ, Sch Med, Dept Radiol, Istanbul, Turkey; [Demir, Safiye Koculu] Demiroglu Bilim Univ, Sch Med, Dept Infect Dis, Istanbul, Turkey; [Cevik, Esin] Istanbul Florence Nightingale Hosp, Dept Infect Dis, Istanbul, Turkey; [Eken, Egemen; Gokkaya, Zafer] Demiroglu Bilim Univ, Sch Med, Dept Anesthesiol, Istanbul, Turkey; [Cagatay, Yonca] Istanbul Florence Nightingale Hosp, Dept Rheumatol, Istanbul, Turkey | en_US |
dc.authorid | Gur Ozcan, Seray Gizem/0000-0003-3938-9802 | |
dc.identifier.pmid | 35156638 | en_US |
dc.identifier.wos | WOS:000860841000003 | en_US |
dc.authorwosid | Gur Ozcan, Seray Gizem/JPA-3113-2023 | |
dc.identifier.trdizinid | 1122354 | en_US |