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Advances in Transplant

Columbia Physicians Examine the Safety and Efficacy of Tocilizumab for the Treatment of Severe COVID-19 Infection

Researchers at NewYork-Presbyterian/Columbia examine the safety and efficacy of tocilizumab for the treatment of severe COVID-19 infection in 29 solid organ transplant recipients and 29 matched controls.

  • In a retrospective matched cohort study, Columbia researchers examine the safety and efficacy of the anti-interleukin (IL)-6-receptor monoclonal antibody tocilizumab for the treatment of severe COVID-19 infection in solid organ transplant recipients.
  • The cohort included 29 solid organ transplant recipients from NewYork-Presbyterian/Columbia who were hospitalized with COVID-19 infection and 29 controls who were matched for age, hypertension, and chronic kidney disease. Controls were additionally matched for potential confounding factors such as administration of high dose corticosteroids for COVID-19.
  • After matching, tocilizumab appeared to be safe but showed no clinical benefit—the rates of mortality, hospital discharge, secondary infections, or intubation were not significantly different.  
  • The authors note that although tocilizumab may not suppress the immune system as much as concurrent high dose steroid therapy in this already immunosuppressed transplant recipient population, there may be subsets of patients who could benefit from this class of agents.
  • Patients who received tocilizumab were more likely to be in the ICU (62% vs 28%; P=0.008), be mechanically ventilated (62% vs 21%; P=0.03), on new renal replacement therapy (34% vs. O%; P=0.001), and had a longer length of stay—suggesting more severe disease.
  • Transplant recipients who received tocilizumab had a longer time from COVID-19 diagnosis to last follow-up, hospital discharge, or death than the matched control group (22 vs. 14 days; P=0.03).

Read more:

Pereira MR, Aversa MM, Farr MA, Miko BA, Aaron JG, Mohan S, Cohen DJ, Husain SA, Ratner LE, Arcasoy S, Uriel N, Zheng EX, Fox AN Tsapepas DS, Emond JC, Verna EC.‬ Tocilizumab for severe COVID-19 in solid organ transplant recipients: a matched cohort study. American J Transplant. 2020;20(11):3198-3205.

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We are committed to sharing the lessons we’ve learned from the pandemic with other centers in order to provide optimal care for patients and ensure safety for providers. In light of SARS-COV2, the Lung Transplant Program at NewYork-Presbyterian is taking special precautions. Currently, we are performing transplant procedures and providing non-emergency telemedicine visits. To refer a patient, please call (212) 305-7771.

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