Thread by @leticiakawano

1/ Our study is out on the @bmj_latest 🤩

TOCILIZUMAB added to the standard of care did not improve clinical outcomes in hospitalized pts with severe Covid19

Let me walk you through the results

2/ Baseline characteristics: ~57yo, around 1/2 of the patients on low flow O2, ~15% on IMV; 20-40% on NIV/HF (random imbalance between groups)

70% of the patients were using steroids at baseline

These pts had high CRP (higher in the control), high LDH, high ferritin:

3/ Even though, at baseline, the control group seemed to have more severe cases than TOC group (> n. of pts on NIV/HF), the proportion of deaths was higher among TOC group from 8 days of FUP on.

PS: ⬆️ death but no ⬆️ IMV 🤔

Death causes: ARF or multiorgan system failure

4/ The darker the purple the worse the outcome at 15 days. Clearly the TOC group did worse than the control group.

5/ This is in contrast to the + effect of TOC seen on REMAP-CAP. Our study is smaller (n=129) but still these contrasting results should be further explored (looking FW to RECOVERY trial data)

Could there b a Covid subgroup that benefits from TOC while another is harmed? (rare)

6/ FYI we really looked into details of the data, @damiani_petri can tell, right, Lucas (our super statistician)?🤣 And it does not seem that our result is the result of a bias. Secondary endpoints and sensitivity analyses (not shown) support our results...🤔

7/ Link for the article: bmj.com/content/372/bm…