Experience with the use of siltuximab in patients with SARS-CoV-2 infection

• DOI: 10.37201/req/045.2021
• Publication Date: 2021-05-13T11:20:41Z
• Authors: Fernanda Meira; Laia Albiach; Cristina Carbonell; José-Ángel Martín...; Mercedes Martín-O...; Laura Linares; Irene Macaya; Daiana Agüero; Juan Ambrosioni; Marta Bodro; Celia Cardozo; Mariana Chumbita; Lorena De la Mora; Nicole García-Pouton; Carolina Garcia-V...; Ana González-Cordón; Marta Hernández-M...; Alexy Inciarte; Montserrat Laguno; Lorna Leal; Laura Morata; Pedro Puerta-Alcalde; Verónica Rico; Laura Letona; Alberto Cózar-Llistó; Gerard Dueñas; Montserrat Solá; Berta Torres; Jhon Rojas; Antonio Moreno; Estela Moreno-García; Manuel Torres; José A Martínez; Alex Soriano; Felipe García
• Keywords: Male; Salvage Therapy; Original; Interleukin-6; Antibodies, Monoclonal; COVID-19; Middle Aged; Antibodies, Monoclonal, Humanized; COVID-19 Drug Treatment; 3. Good health; 03 medical and health sciences; C-Reactive Protein; Treatment Outcome; 0302 clinical medicine; Hypertension; Disease Progression; Humans; Female; Cytokine Release Syndrome; Aged; Retrospective Studies

Objectives. The study aims to describe characteristics and clinical outcome of patients with SARS-CoV-2 infection that received siltuximab according to a protocol that aimed to early block the activity of IL-6 to avoid the progression of the inflammatory flare. Patients and methods. Retrospective review of the first 31 patients with SARS-CoV-2 treated with siltuximab, in Hospital Clinic of Barcelona or Hospital Universitario Salamanca, from March to April 2020 with positive polymerase-chain reaction (PCR) from a nasopharyngeal swab. Results. The cohort included 31 cases that received siltuximab with a median (IQR) age of 62 (56-71) and 71% were males. The most frequent comorbidity was hypertension (48%). The median dose of siltuximab was 800 mg ranging between 785 and 900 mg. 7 patients received siltuximab as a salvage therapy after one dose of tocilizumab. At the end of the study, a total of 26 (83.9) patients had been discharged alive and the mortality rate was 16.1% but only 1 out of 24 that received siltuximab as a first line option (4%). Conclusions. Siltuximab is a well-tolerated alternative to tocilizumab when administered as a first line option in patients with COVID-19 pneumonia within the first 10 days from symptoms onset and high C-reactive protein.