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Early Use of IL-6 Inhibitors May Improve COVID-19 Outcomes

Mortality, risk for intubation lower with IL6ri use in severe COVID-19 stage IIB versus stage III

THURSDAY, Aug. 6, 2020 (HealthDay News) -- For patients with severe COVID-19, administration of an interleukin-6 receptor inhibitor (IL6ri) earlier in the disease course is associated with improved outcomes, according to a study published online July 25 in the International Journal of Infectious Diseases.

Pranay Sinha, M.D., from the Boston University School of Medicine, and colleagues conducted an observational study to determine the optimal timing of IL6ri administration for COVID-19 patients. IL6ri was initially reserved for critically ill patients, but treatment was liberalized to patients with lower oxygen requirement after review. Patients were classified as those requiring ≤45 percent fraction of inspired oxygen (FiO2: stage IIB) and those requiring >45 percent FiO2 (stage III) at administration of IL6ri.

A total of 255 COVID-19 patients were treated with IL6ri (149 and 106 stage IIB and stage III, respectively). The researchers found that mortality was lower for patients treated in stage IIB versus stage III (adjusted hazard ratio, 0.24). Overall, 85.5 percent of patients were discharged alive. Patients treated in stage IIB were more and less likely to be discharged and intubated, respectively (adjusted hazard ratios, 1.43 and 0.43, respectively).

"The greatest benefit with IL6ri use was seen in patients who received the drug in an earlier stage, prior to critical respiratory decompensation, showing the importance of prompt testing and treatment," Sinha said in a statement. "We speculate that immunomodulatory drugs like IL6ri or dexamethasone may be more effective before immune-mediated damage has occurred."

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