The use of Tocilizumab in COVID-19 critically ill patients with renal impairment: a multicenter, cohort study
AbstractTocilizumab (TCZ) is recommended in patients with COVID-19 who require oxygen therapy or ventilatory support. Despite the wide use of TCZ, little is known about its safety and effectiveness in patients with COVID-19 and renal impairment. Therefore, this study evaluated the safety and effecti...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2023-12-01
|
| Series: | Renal Failure |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2268213 |
| _version_ | 1797211837061660672 |
|---|---|
| author | Ohoud Aljuhani Khalid Al Sulaiman Ghazwa B Korayem Aisha Alharbi Ali F. Altebainawi Shatha A. Aldkheel Sarah G. Alotaibi Ramesh Vishwakarma Hanan Alshareef Samiah Alsohimi Mashael AlFaifi Abdulrahman Al Shaya Haifa A. Alhaidal Raghad M. Alsubaie Hessah Alrashidi Khalid J. Albarqi Dalal T. Alangari Reem M. Alanazi Noora M. Altaher Hasan M. Al-Dorzi |
| author_facet | Ohoud Aljuhani Khalid Al Sulaiman Ghazwa B Korayem Aisha Alharbi Ali F. Altebainawi Shatha A. Aldkheel Sarah G. Alotaibi Ramesh Vishwakarma Hanan Alshareef Samiah Alsohimi Mashael AlFaifi Abdulrahman Al Shaya Haifa A. Alhaidal Raghad M. Alsubaie Hessah Alrashidi Khalid J. Albarqi Dalal T. Alangari Reem M. Alanazi Noora M. Altaher Hasan M. Al-Dorzi |
| author_sort | Ohoud Aljuhani |
| collection | DOAJ |
| description | AbstractTocilizumab (TCZ) is recommended in patients with COVID-19 who require oxygen therapy or ventilatory support. Despite the wide use of TCZ, little is known about its safety and effectiveness in patients with COVID-19 and renal impairment. Therefore, this study evaluated the safety and effectiveness of TCZ in critically ill patients with COVID-19 and renal impairment. A multicenter retrospective cohort study included all adult COVID-19 patients with renal impairment (eGFR˂60 mL/min) admitted to the ICUs between March 2020 and July 2021. Patients were categorized into two groups based on TCZ use (Control vs. TCZ). The primary endpoint was the development of acute kidney injury (AKI) during ICU stay. We screened 1599 patients for eligibility; 394 patients were eligible, and 225 patients were included after PS matching (1:2 ratio); there were 75 TCZ-treated subjects and 150 controls. The rate of AKI was higher in the TCZ group compared with the control group (72.2% versus 57.4%; p = 0.03; OR: 1.83; 95% CI: 1.01, 3.34; p = 0.04). Additionally, the ICU length of stay was significantly longer in patients who received TCZ (17.5 days versus 12.5 days; p = 0.006, Beta coefficient: 0.30 days, 95% CI: 0.09, 0.50; p = 0.005). On the other hand, the 30-day and in-hospital mortality were lower in patients who received TCZ compared to the control group (HR: 0.45, 95% CI: 0.27, 0.73; p = 0.01 and HR: 0.63, 95% CI: 0.41, 0.96; p = 0.03, respectively). The use of TCZ in this population was associated with a statistically significantly higher rate of AKI while improving the overall survival on the other hand. Further research is needed to assess the risks and benefits of TCZ treatment in critically ill COVID-19 patients with renal impairment. |
| first_indexed | 2024-03-11T16:36:30Z |
| format | Article |
| id | doaj.art-ca2f1083e62d4c88939688b4397622d0 |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-04-24T10:32:50Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-ca2f1083e62d4c88939688b4397622d02024-04-12T14:34:28ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145210.1080/0886022X.2023.2268213The use of Tocilizumab in COVID-19 critically ill patients with renal impairment: a multicenter, cohort studyOhoud Aljuhani0Khalid Al Sulaiman1Ghazwa B Korayem2Aisha Alharbi3Ali F. Altebainawi4Shatha A. Aldkheel5Sarah G. Alotaibi6Ramesh Vishwakarma7Hanan Alshareef8Samiah Alsohimi9Mashael AlFaifi10Abdulrahman Al Shaya11Haifa A. Alhaidal12Raghad M. Alsubaie13Hessah Alrashidi14Khalid J. Albarqi15Dalal T. Alangari16Reem M. Alanazi17Noora M. Altaher18Hasan M. Al-Dorzi19Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi ArabiaPharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi ArabiaDepartment of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi ArabiaPharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi ArabiaPharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster, Ministry of Health, Hail, Saudi ArabiaDepartment of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi ArabiaDepartment of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi ArabiaNorwich Medical School, University of East Anglia, Norwich, UKDepartment of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi ArabiaPharmaceutical Care Services, King Fahad Armed Forces Hospital, Jeddah, Saudi ArabiaPharmaceutical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaPharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi ArabiaCollege of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaCollege of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaCollege of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaCollege of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaCollege of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaCollege of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaCollege of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaKing Abdullah International Medical Research Center, Riyadh, Saudi ArabiaAbstractTocilizumab (TCZ) is recommended in patients with COVID-19 who require oxygen therapy or ventilatory support. Despite the wide use of TCZ, little is known about its safety and effectiveness in patients with COVID-19 and renal impairment. Therefore, this study evaluated the safety and effectiveness of TCZ in critically ill patients with COVID-19 and renal impairment. A multicenter retrospective cohort study included all adult COVID-19 patients with renal impairment (eGFR˂60 mL/min) admitted to the ICUs between March 2020 and July 2021. Patients were categorized into two groups based on TCZ use (Control vs. TCZ). The primary endpoint was the development of acute kidney injury (AKI) during ICU stay. We screened 1599 patients for eligibility; 394 patients were eligible, and 225 patients were included after PS matching (1:2 ratio); there were 75 TCZ-treated subjects and 150 controls. The rate of AKI was higher in the TCZ group compared with the control group (72.2% versus 57.4%; p = 0.03; OR: 1.83; 95% CI: 1.01, 3.34; p = 0.04). Additionally, the ICU length of stay was significantly longer in patients who received TCZ (17.5 days versus 12.5 days; p = 0.006, Beta coefficient: 0.30 days, 95% CI: 0.09, 0.50; p = 0.005). On the other hand, the 30-day and in-hospital mortality were lower in patients who received TCZ compared to the control group (HR: 0.45, 95% CI: 0.27, 0.73; p = 0.01 and HR: 0.63, 95% CI: 0.41, 0.96; p = 0.03, respectively). The use of TCZ in this population was associated with a statistically significantly higher rate of AKI while improving the overall survival on the other hand. Further research is needed to assess the risks and benefits of TCZ treatment in critically ill COVID-19 patients with renal impairment.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2268213Tocilizumabrenal impairmentcovid-19critically illacute kidney injury |
| spellingShingle | Ohoud Aljuhani Khalid Al Sulaiman Ghazwa B Korayem Aisha Alharbi Ali F. Altebainawi Shatha A. Aldkheel Sarah G. Alotaibi Ramesh Vishwakarma Hanan Alshareef Samiah Alsohimi Mashael AlFaifi Abdulrahman Al Shaya Haifa A. Alhaidal Raghad M. Alsubaie Hessah Alrashidi Khalid J. Albarqi Dalal T. Alangari Reem M. Alanazi Noora M. Altaher Hasan M. Al-Dorzi The use of Tocilizumab in COVID-19 critically ill patients with renal impairment: a multicenter, cohort study Renal Failure Tocilizumab renal impairment covid-19 critically ill acute kidney injury |
| title | The use of Tocilizumab in COVID-19 critically ill patients with renal impairment: a multicenter, cohort study |
| title_full | The use of Tocilizumab in COVID-19 critically ill patients with renal impairment: a multicenter, cohort study |
| title_fullStr | The use of Tocilizumab in COVID-19 critically ill patients with renal impairment: a multicenter, cohort study |
| title_full_unstemmed | The use of Tocilizumab in COVID-19 critically ill patients with renal impairment: a multicenter, cohort study |
| title_short | The use of Tocilizumab in COVID-19 critically ill patients with renal impairment: a multicenter, cohort study |
| title_sort | use of tocilizumab in covid 19 critically ill patients with renal impairment a multicenter cohort study |
| topic | Tocilizumab renal impairment covid-19 critically ill acute kidney injury |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2268213 |
| work_keys_str_mv | AT ohoudaljuhani theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT khalidalsulaiman theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT ghazwabkorayem theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT aishaalharbi theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT alifaltebainawi theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT shathaaaldkheel theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT sarahgalotaibi theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT rameshvishwakarma theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT hananalshareef theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT samiahalsohimi theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT mashaelalfaifi theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT abdulrahmanalshaya theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT haifaaalhaidal theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT raghadmalsubaie theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT hessahalrashidi theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT khalidjalbarqi theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT dalaltalangari theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT reemmalanazi theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT nooramaltaher theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT hasanmaldorzi theuseoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT ohoudaljuhani useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT khalidalsulaiman useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT ghazwabkorayem useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT aishaalharbi useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT alifaltebainawi useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT shathaaaldkheel useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT sarahgalotaibi useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT rameshvishwakarma useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT hananalshareef useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT samiahalsohimi useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT mashaelalfaifi useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT abdulrahmanalshaya useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT haifaaalhaidal useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT raghadmalsubaie useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT hessahalrashidi useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT khalidjalbarqi useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT dalaltalangari useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT reemmalanazi useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT nooramaltaher useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy AT hasanmaldorzi useoftocilizumabincovid19criticallyillpatientswithrenalimpairmentamulticentercohortstudy |