Id |
Subject |
Object |
Predicate |
Lexical cue |
T67 |
0-11 |
Sentence |
denotes |
Question 6. |
T68 |
12-93 |
Sentence |
denotes |
Should other immunosuppressive and/or immunomodulatory therapies be administered? |
T69 |
94-248 |
Sentence |
denotes |
Owing to the lack of high-level evidence, administration of tocilizumab to patients with COVID-19 should preferentially occur within the framework of RCT. |
T70 |
249-575 |
Sentence |
denotes |
Off-label use according to local protocols and consent procedures may be considered only in those COVID-19 patients excluded from RCT (or hospitalized where RCT are not available or still to be implemented) and who are worsening while receiving standard supportive care (in the absence of concomitant/superimposed infections). |
T71 |
576-1045 |
Sentence |
denotes |
In our opinion, this could be a reasonable off-label use of tocilizumab in these early phases of the COVID-19 pandemic, although patients and physicians should be aware that currently there is only a non–peer-reviewed, noncomparative, observational experience (very low evidence from an unreviewed cases series) and that it only supports a potential favourable effect on inflammatory signs and symptoms, while there is no information on any possible effect on survival. |
T72 |
1046-1251 |
Sentence |
denotes |
In the absence of clinical studies, we suggest to preferentially administer also other immunosuppressive and/or immunomodulatory therapies (e.g. anakinra, Janus kinase family enzyme inhibitors) within RCT. |
T73 |
1252-1570 |
Sentence |
denotes |
This also applies to modifications of the immune response through high-dose intravenous immunoglobulins or plasma from convalescent patients, which, although promising in small case series, both deserve dedicated RCT investigation to clearly understand their role in impacting COVID-19 outcomes and their tolerability. |