The content of this evidence summary was up to date in February 2021. New evidence may have been published since then. See summaries of product characteristics (SPCs), British national formulary (BNF) or the Medicines and Healthcare products Regulatory Agency (MHRA) or NICE websites for up‑to‑date prescribing information.
Tocilizumab is an interleukin‑6 inhibitor. It has marketing authorisations for rheumatoid arthritis and giant cell arteritis in adults, systemic juvenile idiopathic arthritis and juvenile idiopathic polyarthritis in children 2 years and older, and chimeric antigen receptor T cell-induced severe or life-threatening cytokine release syndrome in adults, young people and children 2 years and older (see the summaries of product characteristics for tocilizumab). Use of tocilizumab for COVID‑19 is off label.
Preliminary evidence from Horby et al. (2021; the RECOVERY study) suggests that tocilizumab is beneficial in adults who have been hospitalised with severe COVID‑19 and have clinical evidence of progressive disease (hypoxia and systemic inflammation).
Preliminary evidence from Gordon et al. (2021; the REMAP‑CAP study) suggests that tocilizumab is beneficial in adults with severe COVID‑19 who are critically ill and receiving respiratory or cardiovascular organ support in an intensive care setting. Tocilizumab was given within about 24 hours of starting organ support.
In these populations, it is possible that any benefit is more likely with earlier use, when disease progression and any developing organ dysfunction may be more reversible.
There is also a related NICE COVID-19 rapid evidence summary on sarilumab for COVID-19.