Outcomes of tocilizumab and sarilumab for hospitalized patients with COVID-19: retrospective study

Abstract Introduction Tocilizumab (TZ) and sarilumab (SL), IL-6 receptor antagonists, were utilized during the pandemic, yet direct comparisons remain limited, particularly in resource-constrained settings facing drug shortages. Hypothesis This study aimed to evaluate whether TZ and SL yield compara...

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Main Authors: Ashraf Mokhtar Madkour, Ashraf Abbas El Maraghy, Boles Raafat Fadly, Ragy Mamdouh Ghaly
Format: Article
Language:English
Published: SpringerOpen 2025-06-01
Series:The Egyptian Journal of Bronchology
Online Access:https://doi.org/10.1186/s43168-025-00423-0
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author Ashraf Mokhtar Madkour
Ashraf Abbas El Maraghy
Boles Raafat Fadly
Ragy Mamdouh Ghaly
author_facet Ashraf Mokhtar Madkour
Ashraf Abbas El Maraghy
Boles Raafat Fadly
Ragy Mamdouh Ghaly
author_sort Ashraf Mokhtar Madkour
collection DOAJ
description Abstract Introduction Tocilizumab (TZ) and sarilumab (SL), IL-6 receptor antagonists, were utilized during the pandemic, yet direct comparisons remain limited, particularly in resource-constrained settings facing drug shortages. Hypothesis This study aimed to evaluate whether TZ and SL yield comparable clinical outcomes in hospitalized patients with severe or critical COVID-19. Methods A retrospective cohort study was conducted at Ain Shams University Obour Hospital (January–December 2021) on 100 severe/critical COVID-19 patients (50 TZ, 50 SL) receiving standard care. Outcomes included mortality, length of stay, care transitions, and adverse events. Results Demographics and baseline severity were comparable between groups. TZ demonstrated significant improvement in level of care compared to SL (p = 0.001). However, in-hospital mortality (8% vs. 20%, p = 0.148), hospital stay (14.6 vs. 15.5 days, p = 0.298), ICU stay, mechanical ventilation rates and P/F ratio change at 96h showed no significant differences. Adverse events, including secondary bacterial infections, gastrointestinal tract bleeding and liver enzyme elevations showed no significant differences between TZ and SL (p =  ≥ 0.885). Conclusion TZ and SL exhibited comparable efficacy and safety in most outcomes, supporting SL as a viable alternative during TZ shortages. This study underscores the importance of context-driven therapeutic decisions in resource-limited settings.
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spelling doaj-art-727e221be6ee4f25a210fa11aa9a0f402025-08-20T02:37:57ZengSpringerOpenThe Egyptian Journal of Bronchology2314-85512025-06-011911710.1186/s43168-025-00423-0Outcomes of tocilizumab and sarilumab for hospitalized patients with COVID-19: retrospective studyAshraf Mokhtar Madkour0Ashraf Abbas El Maraghy1Boles Raafat Fadly2Ragy Mamdouh Ghaly3Department of Chest Diseases, Faculty of Medicine, Ain Shams UniversityDepartment of Chest Diseases, Faculty of Medicine, Ain Shams UniversityDepartment of Chest Diseases, Faculty of Medicine, Ain Shams UniversityDepartment of Chest Diseases, Faculty of Medicine, Ain Shams UniversityAbstract Introduction Tocilizumab (TZ) and sarilumab (SL), IL-6 receptor antagonists, were utilized during the pandemic, yet direct comparisons remain limited, particularly in resource-constrained settings facing drug shortages. Hypothesis This study aimed to evaluate whether TZ and SL yield comparable clinical outcomes in hospitalized patients with severe or critical COVID-19. Methods A retrospective cohort study was conducted at Ain Shams University Obour Hospital (January–December 2021) on 100 severe/critical COVID-19 patients (50 TZ, 50 SL) receiving standard care. Outcomes included mortality, length of stay, care transitions, and adverse events. Results Demographics and baseline severity were comparable between groups. TZ demonstrated significant improvement in level of care compared to SL (p = 0.001). However, in-hospital mortality (8% vs. 20%, p = 0.148), hospital stay (14.6 vs. 15.5 days, p = 0.298), ICU stay, mechanical ventilation rates and P/F ratio change at 96h showed no significant differences. Adverse events, including secondary bacterial infections, gastrointestinal tract bleeding and liver enzyme elevations showed no significant differences between TZ and SL (p =  ≥ 0.885). Conclusion TZ and SL exhibited comparable efficacy and safety in most outcomes, supporting SL as a viable alternative during TZ shortages. This study underscores the importance of context-driven therapeutic decisions in resource-limited settings.https://doi.org/10.1186/s43168-025-00423-0
spellingShingle Ashraf Mokhtar Madkour
Ashraf Abbas El Maraghy
Boles Raafat Fadly
Ragy Mamdouh Ghaly
Outcomes of tocilizumab and sarilumab for hospitalized patients with COVID-19: retrospective study
The Egyptian Journal of Bronchology
title Outcomes of tocilizumab and sarilumab for hospitalized patients with COVID-19: retrospective study
title_full Outcomes of tocilizumab and sarilumab for hospitalized patients with COVID-19: retrospective study
title_fullStr Outcomes of tocilizumab and sarilumab for hospitalized patients with COVID-19: retrospective study
title_full_unstemmed Outcomes of tocilizumab and sarilumab for hospitalized patients with COVID-19: retrospective study
title_short Outcomes of tocilizumab and sarilumab for hospitalized patients with COVID-19: retrospective study
title_sort outcomes of tocilizumab and sarilumab for hospitalized patients with covid 19 retrospective study
url https://doi.org/10.1186/s43168-025-00423-0
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AT bolesraafatfadly outcomesoftocilizumabandsarilumabforhospitalizedpatientswithcovid19retrospectivestudy
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