Tocilizumab combined with favipiravir in the treatment of COVID-19: A multicenter trial in a small sample size
Zhaao et al.
, Tocilizumab combined with favipiravir in the treatment of COVID-19: A multicenter trial in a small sample size
, Biomedicine & Pharmacotherapy, doi:10.1016/j.biopha.2020.110825
Small study with 14 combined favipiravir/tocilizumab, 7 favipiravir, and 5 tocilizumab patients suggesting that tocilizumab combined with or without favipiravir can improve pulmonary inflammation and inhibit progression.
Zhaao et al., 30 Sep 2020, peer-reviewed, 12 authors.
Abstract: Biomedicine & Pharmacotherapy 133 (2021) 110825
Contents lists available at ScienceDirect
Biomedicine & Pharmacotherapy
journal homepage: www.elsevier.com/locate/biopha
Tocilizumab combined with favipiravir in the treatment of COVID-19: A
multicenter trial in a small sample size
Hong Zhao a, b, 1, Qi Zhu c, 1, Chi Zhang a, 1, Jiawen Li a, Ming Wei d, Yuhong Qin e, Guilin Chen c,
Ke Wang d, Junhua Yu f, Zhao Wu a, Xianxiang Chen g, *, Guiqiang Wang a, b, **
Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, China
Peking University International Hospital, Beijing, China
Department of Tuberculosis, Wuhan Pulmonary Hospital, Wuhan, 430030, China
Wuhan Jinyintan Hospital, No. 1 Yintan Road, Dongxihu District, Wuhan, 430040, China
Emergency Department of Peking University International Hospital, Life-Science Park, Changping District, Beijing, 102206, China
Ezhou Central Hospital, 9 Wenxing Road, Ezhou City, Hubei Province, 463000, China
Surgical Department, Wuhan Pulmonary Hospital, No. 28 Baofeng Road, Wuhan, 430030, China
A R T I C L E I N F O
A B S T R A C T
Background: Since December 2019, COVID-19 has spread to almost every corner of the world. In theory, toci
lizumab and favipiravir are considered to be reliable drugs for the treatment of COVID-19 with elevated IL-6. We
aimed to assess the efficacy and safety of tocilizumab combined with favipiravir in patients with COVID-19.
Methods: This was a multicenter trial in adults with COVID-19. Patients were randomly assigned (3:1:1) to a 14day combination of favipiravir combined with tocilizumab (combination group), favipiravir, and tocilizumab.
The primary outcome was the cumulative lung lesion remission rate (lung CT examination indicated absorption
of lung inflammation).
Results: Between Feb 2 and March 15, 2020, 26 patients were recruited; 14 were randomly assigned to the
combination group, 7 were assigned to the favipiravir group and 5 were assigned to the tocilizumab group. The
cumulative lung lesion remission rate at day 14 was significantly higher in combination group as compared with
favipiravir group (P = 0.019, HR 2.66 95 % CI [1.08–6.53]). And there was also a significant difference between
tocilizumab and favipivavir (P = 0.034, HR 3.16, 95 % CI 0.62–16.10). In addition, there was no significant
difference between the combination group and the tocilizumab group (P = 0.575, HR 1.28 95 %CI 0.39–4.23).
Furthermore, combined therapy can also significantly relieve clinical symptoms and help blood routine to return
to normal. No serious adverse events were reported.
Conclusion: Tocilizumab combined with or without favipiravir can effectively improve the pulmonary inflam
mation of COVID-19 patients and inhibit the deterioration of the disease.
is less effective
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