Рецепт. 2021; 24: 773-783
Практика применения тоцилизумаба у пациентов с COVID-19 (результаты ретроспективного мониторинга)
https://doi.org/10.34883/PI.2021.24.6.001Аннотация
Тоцилизумаб – рекомбинантное гуманизированное моноклональное антитело к человеческому рецептору интерлейкина-6 (ИЛ-6) из подкласса иммуноглобулинов IgG1.
Цель. Установить обоснованность применения тоцилизумаба, эффективность, переносимость и безопасность режима дозирования тоцилизумаба при включении его в схему лечения пациентов с коронавирусной инфекцией.
Материалы и методы. Проведено ретроспективное исследование методом ретроспективного мониторинга с использованием данных медицинских историй болезни стационарного пациента за период декабрь 2020 г. – январь 2021 г. Предметом анализа являлись сведения о количестве тоцилизумаба, реализованного в стационаре, по данным аптеки стационара; клиническая характеристика пациентов, которым тоцилизумаб назначался; особенности использования тоцилизумаба (дозы, кратность, время введения); исходы заболевания у пациентов. В исследовании принимали участие врачи – клинические фармакологи учреждений здравоохранения г. Минска, Гомельской, Гродненской и Брестской областей, ГУ «РНПЦ пульмонологии и фтизиатрии».
Выводы. Назначение тоцилизумаба было обосновано и проводилось в соответствии с показаниями, отраженными в приказе Министерства здравоохранения Республики Беларусь от 11.11.2020 № 1195 «Временные рекомендации об организации оказания помощи пациентам с инфекцией COVID-19».
Список литературы
1. Guaraldi G., Meschiari M., Cozzi-Lepri A. (2020) Tocilizumab in patients with severe COVID-19: a retrospective cohort study. Lancet Rheumatol., vol. 2, no 8, pp. 474–484.
2. Favalli E.G., Caporali R. (2020) GM-CSF in the treatment of COVID-19: a new conductor in the pathogenesis of cytokine storm? Lancet Rheumatol., vol. 2, no 8, pp. 448–449.
3. Fu B., Xu X., Wei H. (2020) Why tocilizumab could be an effective treatment for severe COVID-19? J TranslMed., vol. 18, no 1, p. 164.
4. Guaraldi G., Meschiari M., Cozzi-Lepri A. (2020) Tocilizumab in patients with severe COVID-19: a retrospective cohort study. Lancet Rheumatol., vol. 2, no 8, pp. 474–484.
5. Xu X., Han M., Li T., Sun W. (2020) Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl AcadSci USA, vol. 117, no 20, pp. 10970–5.
6. Zhang C., Wu Z., Li J.W., Zhao H., Wang G.Q. (2020) Cytokine release syndrome in severe COVID-19: interleukin-6 receptor antagonist tocilizumab may be the key to reduce mortality. Int J Antimicrob Agents., vol. 55, no 5, p. 105954.
7. Zhou F., Yu T., Du R. (2020) Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, vol. 395, no 10229, pp. 1054–62.
8. Prikaz Ministerstva zdravoohraneniya Respubliki Belarus’ ot 11.11.2020 № 1195. Order of the Ministry of Health of the Republic of Belarus dated 11.11.2020 No. 1195. Recommendations (temporary) on the organization of medical care for patients with COVID-19 infection, 57 p. Available at: https://drive.google.com/file/d/1-0njxgMKBRVgsu4Cz3-3q5B_KlrINiER/view.
9. (2020) Safety of using remdesivir and tocilizumab in the treatment of COVID-19. Safety and risk of pharmacotherapy, no 8 (3), pp. 160–162. Available at: https://doi.org/10.30895/2312-7821-2020-8-3-160-162.
Recipe. 2021; 24: 773-783
Practice of Tocilisumab Application in Patients with COVID-19 (Results of Retrospective Monitoring)
https://doi.org/10.34883/PI.2021.24.6.001Abstract
Tocilizumab is a recombinant humanized monoclonal antibody to the human interleukin-6 (IL-6) receptor from the IgG1 immunoglobulin subclass.
Purpose. To establish the validity of the use of tocilizumab, as well as the efficacy, tolerability and safety of the dosing regimen of tocilizumab when included in the treatment regimen for patients with coronavirus infection.
Materials and methods. A retrospective study was carried out using the method of retrospective monitoring using data from medical histories of an inpatient for the period December 2020 – January 2021. The subject of the analysis was information on the amount of tocilizumab realaized in the hospital according to the data of the hospital pharmacy; clinical characteristics of patients to whom tocilizumab was prescribed; features of the use of tocilizumab (dose, frequency, time of administration); disease outcomes in patients. Clinical pharmacologists take part from clinics in Minsk, Gomel, Grodno and Brest regions, the Republican Scientific and Practical Center for Pulmonology and Phthisiology.
Conclusions. The appointment of tocilizumab was justified and carried out in accordance with the indications reflected in the Order of the Ministry of Health of the Republic of Belarus dated 11.11.2020 No. 1195 "Temporary recommendations on the organization of care for patients with COVID-19 infection".
References
1. Guaraldi G., Meschiari M., Cozzi-Lepri A. (2020) Tocilizumab in patients with severe COVID-19: a retrospective cohort study. Lancet Rheumatol., vol. 2, no 8, pp. 474–484.
2. Favalli E.G., Caporali R. (2020) GM-CSF in the treatment of COVID-19: a new conductor in the pathogenesis of cytokine storm? Lancet Rheumatol., vol. 2, no 8, pp. 448–449.
3. Fu B., Xu X., Wei H. (2020) Why tocilizumab could be an effective treatment for severe COVID-19? J TranslMed., vol. 18, no 1, p. 164.
4. Guaraldi G., Meschiari M., Cozzi-Lepri A. (2020) Tocilizumab in patients with severe COVID-19: a retrospective cohort study. Lancet Rheumatol., vol. 2, no 8, pp. 474–484.
5. Xu X., Han M., Li T., Sun W. (2020) Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl AcadSci USA, vol. 117, no 20, pp. 10970–5.
6. Zhang C., Wu Z., Li J.W., Zhao H., Wang G.Q. (2020) Cytokine release syndrome in severe COVID-19: interleukin-6 receptor antagonist tocilizumab may be the key to reduce mortality. Int J Antimicrob Agents., vol. 55, no 5, p. 105954.
7. Zhou F., Yu T., Du R. (2020) Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, vol. 395, no 10229, pp. 1054–62.
8. Prikaz Ministerstva zdravoohraneniya Respubliki Belarus’ ot 11.11.2020 № 1195. Order of the Ministry of Health of the Republic of Belarus dated 11.11.2020 No. 1195. Recommendations (temporary) on the organization of medical care for patients with COVID-19 infection, 57 p. Available at: https://drive.google.com/file/d/1-0njxgMKBRVgsu4Cz3-3q5B_KlrINiER/view.
9. (2020) Safety of using remdesivir and tocilizumab in the treatment of COVID-19. Safety and risk of pharmacotherapy, no 8 (3), pp. 160–162. Available at: https://doi.org/10.30895/2312-7821-2020-8-3-160-162.
