Rapid analysis of local data to inform off-label tocilizumab use early in the COVID-19 pandemic

• DOI: 10.1016/j.hjdsi.2021.100581
• Publication Date: 2021-09-09T05:47:18Z
• Authors: Camille E. Morgan; Casey A. Rimland; Griffin J. Bell; Min K. Kim; Tanner Hedrick; Ashley Marx; Brian Bramson; Heidi Swygard; Sonia Napravnik; John L. Schmitz; Shannon S. Carson; William A. Fischer; Joseph J. Eron; Cynthia L. Gay; Jonathan B. Parr
• Keywords: SARS-CoV-2; Clinical Decision-Making; Uncertainty; Off-Label Use; Antibodies, Monoclonal, Humanized; Article; COVID-19 Drug Treatment; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Humans; Cytokine Release Syndrome; Pandemics

The interleukin-6 receptor antagonist tocilizumab became widely used early in the coronavirus disease 2019 (COVID-19) pandemic based on small observational studies that suggested clinical benefit in COVID-19 patients with a hyperinflammatory state. To inform our local treatment algorithms in the absence of randomized clinical trial results, we performed a rapid analysis of the first 11 hospitalized COVID-19 patients treated with tocilizumab at our academic medical center. We report their early clinical outcomes and describe the process by which we assembled a team of diverse trainees and stakeholders to extract, analyze, and disseminate data during a time of clinical uncertainty.