Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.

Abstract (PubMed)

BACKGROUND: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. METHODS: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to receive tocilizumab (8 mg/kg bodyweight intravenously, up to a maximum of 800 mg, with a second dose given 12-24h later if no improvement) or usual care alone. The primary outcome was 28-day mortality. RESULTS: 4116 patients were randomly assigned to tocilizumab (n=2022) or usual care (n=2094). 621 (31%) patients in the tocilizumab group died within 28 days compared with 729 (35%) patients in the usual care group (rate ratio 0.85; 95% CI 0.76-0.94; p=0.0028). Patients in the tocilizumab group were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1.22; 95% CI 1.12-1.33; p<0.0001). CONCLUSIONS: In patients hospitalised with COVID-19 with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes.