Coronavirus disease 2019 (COVID-19)

Active Ingredient: Tocilizumab

Indication for Tocilizumab

Population group: only adults (18 years old or older)
Therapeutic intent: Curative procedure

Tocilizumab is indicated for the treatment of COVID-19 in adults who are receiving systemic corticosteroids and require supplemental oxygen or mechanical ventilation.

For this indication, competent medicine agencies globally authorize below treatments:

8 mg/kg once, with the possibillity of one additional dose

For:

Dosage regimens

Intravenous, 8 milligrams tocilizumab per kilogram of body weight, 1 to 2 doses in total.

Detailed description

The recommended posology for treatment of COVID-19 is a single 60-minute intravenous infusion of 8 mg/kg body weight in patients who are receiving systemic corticosteroids and require supplemental oxygen or mechanical ventilation. If clinical signs or symptoms worsen or do not improve after the first dose, one additional infusion of tocilizumab 8 mg/kg may be administered. The interval between the two infusions must be at least 8 hours.

For individuals whose body weight is more than 100 kg, doses exceeding 800 mg per infusion are not recommended.

Administration of tocilizumab is not recommended in patients with COVID-19 who have any of the following laboratory abnormalities:

Laboratory test typeLaboratory valueAction
Liver enzyme> 10 × ULNAdministration of tocilizumab
is not recommended
Absolute neutrophil count< 1 × 109/L
Platelet count< 50 × 103/μL

Cytokine Release Syndrome (CRS)

The recommended posology for treatment of CRS given as a 60-minute intravenous infusion is 8 mg/kg in patients weighing greater than or equal to 30 kg or 12 mg/kg in patients weighing less than 30 kg. Tocilizumab can be given alone or in combination with corticosteroids.

If no clinical improvement in the signs and symptoms of CRS occurs after the first dose, up to 3 additional doses of tocilizumab may be administered. The interval between consecutive doses must be at least 8 hours. Doses exceeding 800 mg per infusion are not recommended in CRS patients.

Patients with severe or life-threatening CRS frequently have cytopenias or elevated ALT or AST due to the underlying malignancy, preceding lymphodepleting chemotherapy or the CRS.

Dosage considerations

Intravenous infusion over 1 hour. If signs and symptoms of an infusion-related reaction occur, the infusion needs to be slowed or stopped and appropriate medicinal product/supportive care must be administered immediately.

Active ingredient

Tocilizumab

Tocilizumab binds specifically to both soluble and membrane-bound IL-6 receptors (sIL-6R and mIL-6R). IL-6 is involved in diverse physiological processes such as T-cell activation, induction of immunoglobulin secretion, induction of hepatic acute phase protein synthesis and stimulation of haemopoiesis. IL-6 has been implicated in the pathogenesis of diseases including inflammatory diseases, osteoporosis and neoplasia.

Read more about Tocilizumab

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