Adverse reactions in patients with COVID-19 after using tocilizumab

doi:10.19803/j.1672-8629.20230214

Abstract

Abstract: Objective To study the adverse drug reactions (ADR) caused by tocilizumab in patients with Corona Virus Disease 2019 (COVID-19) and to provide clinical reference. Methods Cases of adverse drug reactions caused by tocilizumab between December 1, 2022 and January 31, 2023 in our hospital were retrospectively analyzed to summarize the characteristics of ADR associated with tocilizumab. Domestic and overseas databases were searched to collect the cases of ADR due to tocilizumab reported as of January 31, 2023. The included patients were analyzed in terms of age, gender, weight, high-risk factors, types of COVID-19, time for administration of tocilizumab, regimens and durations, other drugs for COVID-19, onset time of adverse reactions, length of hospital stay and clinical outcomes. Results A total of 48 patients with COVID-19 were administered with tocilizumab, seven of whom experienced ADR within about 5 [(inter quartile range (IQR) 1-7] days of dosing, including 6 cases of (85.74%) thrombocytopenia, 3 cases of (42.86%) infections, and 1 case of (14.29%) liver function abnormalities. The median length of hospitalization was 19 (IQR 16-41) days, and 4 (57.14%) patients died during hospitalization. The literature search retrieved 14 case reports with a total of 30 COVID-19 patients with ADR induced by tocilizumab. ADR occurred about 11 (IQR 4-14.5) days after the first dose of tocilizumab and included 16 cases of (53.33%) infections, 9 cases of (30%) liver damage, 5 cases of (16.67%) intestinal ulcers/enteric perforation, and 3 cases of (10%) thrombocytopenia. The median length of hospitalization of patients was 29 (IQR 19-50) days and 9 (30%) patients died during hospitalization. Conclusion Patients with COVID-19 should be alerted to ADR such as infections, liver damage, and thrombocytopenia during the use of tocilizumab.

Key words: tocilizumab, COVID-19, adverse drug reaction, thrombocytopenia, infection, liver injury, safety

CLC Number:

LI Jing, XU Ye, LIU Ranjia, PAN Chen, CUI Xiangli. Adverse reactions in patients with COVID-19 after using tocilizumab[J]. Chinese Journal of Pharmacovigilance, 2023, 20(9): 1049-1053.

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