IL-6 inhibitors in COVID-19

U.K. health officials now say clinicians should consider using the interleukin-6 (IL-6) inhibitor tocilizumab, with sarilumab as an alternative, for critically ill COVID-19 patients. The recommendation came a day after findings from a randomized trial were posted on the preprint server medRxiv. In that trial, roughly 800 ICU patients were assigned to receive tocilizumab, sarilumab, or standard care within 24 hours of ICU admission. The in-hospital mortality rate was 28% with tocilizumab, 22% with sarilumab, and 36% with standard care. U.K. officials note that 80% of trial participants also received corticosteroids; thus, the benefit from IL-6 inhibitors “is thought to be supplementary to those from corticosteroids.” Prior findings on IL-6 inhibitors for COVID-19 have been mixed, and the U.S. National Institutes of Health currently recommends against their use outside of clinical trials.

U.K. position statement on IL-6 inhibitors 

IL-6 inhibitor trial on medRxiv (not peer-reviewed)