Interleukin-6 receptor antagonists in critically ill patients with COVID-19

The REMAP-CAP international study investigated the potential benefit of the interleukin-6 receptor antagonists tocilizumab and sarilumab in the critically ill COVID-19 patient population. The sample population included adults with suspected or confirmed disease who were admitted to intensive care units. Within 24 hours of beginning organ or respiratory support, 353 patients were randomized to tocilizumab, 48 were assigned to sarilumab, and 402 were allocated to usual care. During 3-week followup, the cohorts achieved 10, 11, and 0 support-free days, respectively. Researchers estimated the probability of superiority of tocilizumab over standard care at more than 99.9% and at 99.5% for sarilumab vs. usual care. Treatment with the IL-6 receptor antagonists also improved 90-day survival.