Efficacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients
Sarhan et al.
, Efficacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe..
, Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.10.024, NCT04779047
Small 108 patient RCT comparing HCQ vs. remdesivir in very late stage treatment. All patients received tocilizumab. There were significant unadjusted baseline differences in ventilation and ICU admission. NCT04779047 (history)
Although the 26% lower mortality is not statistically significant, it is consistent with the significant 22% lower mortality [18‑27%]
from meta analysis of the 232 mortality results to date
This study is excluded in the after exclusion results of meta
very late stage, >50% on oxygen/ventilation at baseline; significant unadjusted differences between groups.
risk of death, 25.7% lower, RR 0.74, p = 0.39, treatment 12 of 56 (21.4%), control 15 of 52 (28.8%), NNT 13.
risk of no hospital discharge, 25.7% lower, RR 0.74, p = 0.39, treatment 12 of 56 (21.4%), control 15 of 52 (28.8%), NNT 13.
hospitalization time, 25.0% higher, relative time 1.25, p = 0.06, treatment 56, control 52.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sarhan et al., 2 Nov 2021, Randomized Controlled Trial, Egypt, peer-reviewed, 8 authors, study period 1 October, 2020 - 10 March, 2021, this trial compares with another treatment - results may be better when compared to placebo, trial NCT04779047 (history)
Abstract: Journal Pre-proof
Efﬁcacy of the early treatment with tocilizumab-hydroxychloroquine and
tocilizumab-remdesivir in severe COVID-19 Patients
Rania M. Sarhan, Hadeer S. Harb, Ahmed E. Abou Warda, Mounir
M. Salem-Bekhit, Faiyaz Shakeel, Sami A. Alzahrani, Yasmin M.
Madney, Marian S. Boshra
To appear in:
Journal of Infection and Public Health
10 July 2021
12 October 2021
25 October 2021
Please cite this article as: Sarhan RM, Harb HS, Abou Warda AE, Salem-Bekhit MM, Shakeel
F, Alzahrani SA, Madney YM, Boshra MS, Efﬁcacy of the early treatment with
tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients,
Journal of Infection and Public Health (2021), doi: https://doi.org/10.1016/j.jiph.2021.10.024
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Efficacy of the early treatment with tocilizumab- hydroxychloroquine and
tocilizumab-remdesivir in severe COVID-19 Patients
Short title: Effect of different antiviral and anti-inflammatory drugs in COVID-19
M Sarhan , 1 Hadeer S. Harb, 2 Ahmed E. Abou Warda, 3,4 Mounir M. Salem-Bekhit,
Shakeel, 3 Sami Ali Alzahrani, 1 Yasmin M. Madney, 1 Marian S. Boshra
Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Benisuef, Egypt.
2Clinical Pharmacy Department, Faculty of Pharmacy, October 6 University, Giza,
3Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh,
11451, Saudi Arabia.
4Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar
University, Cairo, Egypt.
Corresponding author: Rania M Sarhan
ORCID Number: 0000-0002-0781-6454
Mobile phone: 0201008789509
Mailing address: Ahmed Hegazy Street, Faculty of pharmacy, Beni-Suef, Egypt
Background: The effectiveness of the best combination between different antiviral
and anti-inflammatory drugs stills an interest in the treatment of COVID19 infection.
Patients and Methods: A prospective randomized cohort study comprised 108 adult
patients with confirmed PCR COVID 19 infection with systemic hyper inflammation
state, divided into two groups according to the treatment regimen, 56 in the
tocilizumab- hydroxychloroquine (TCZ-HCQ) treatment, and 52 in the tocilizumabremdesivir (TCZ-RMV) treatment. The first group received a combination of I.V.
TCZ (400 -800 mg every 24 hours for only two doses) and HCQ (400 mg twice in the
first day then 200 mg twice for 5 days) while the second group of patients received
I.V. RMV of 200 mg on day 1 followed by 100 mg once daily infused over 60
minutes for 5 days with the same TCZ regimen used in the first group. All clinical
parameters and laboratory investigations were assessed before and after..
is less effective
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