Introduction
Coronavirus disease 2019 (Covid-19)
pneumonia may be associated with a dysregulated immune response and
hyperinflammation, which can lead to or exacerbate acute respiratory
distress syndrome and multiorgan failure. Higher levels of interleukin-6
have been positively correlated with cases of critical and severe
Covid-19, whereas lower levels of interleukin-6 have been correlated
with mild disease. Therefore, tocilizumab has been recommended by
several treatment guidance or consensus as an optional therapy for
Covid-19[1, 2], which was an unapproved indication
of tocilizumab.
Tocilizumab was launched in China in
2013 which was licensed to treat rheumatoid arthritis (RA) and
systemic juvenile idiopathic
arthritis (sJIA). The main active ingredient of tocilizumab is
recombinant humanized anti-interleukin-6 receptor(IL-6R) monoclonal
antibody that can specifically bind the membrane-bound IL-6 receptor
(mIL6R) and soluble IL-6 receptor (sIL6R), thereby inhibiting signal
transduction. Recent research has revealed, IL-6R play a key role in
pathogenesis of a variety of immune diseases like Takayasu
arterits[3], Adult-onset Still’s
disease[4], et al. As more and more clinical
trials and relevant studies around off-label use of tocilizumab have
been implemented, some reliable evidences indicated that the treatment
effect of tocilizumab not only be restricted to RA and JIA. Although
some indications are not approved in China currently, the off-label use
of tocilizumab is quite common in hospital especially in Chinese
tertiary care hospital. The purpose of this study is to summarize and
organize the clinical use situation of tocilizumab in Peking Union
Medical College Hospital.