107 IL-6 inhibitors in hospitalised COVID-19 patients 5 1.5 and twice as many patients could likely be treated with a low dose tocilizumab compared with 8 mg/kg, meaning that those 500 treatments can be used to treat 750-1000 patients with low dose tocilizumab. However, on average an additional 1 in 39 would die by choosing a low dose instead of 8 mg/kg, leading to 11-14 lives saved in this population (30 to 40 by giving them 8 mg/kg tocilizumab instead of placebo, minus 19 to 26 because of the low dose), as opposed to the 20 lives saved when 500 people are treated with 8 mg/kg. However, there may be other (ethical) considerations, such as equal distribution of medication We found that in the complete hospital population, sarilumab, low dose tocilizumab and fixed dose tocilizumab led to worse survival compared to the 8 mg/kg group. The 8 mg/kg would therefore be the first-choice treatment option. In case of ongoing drug shortages using fixed dose or low dose tocilizumab in order to treat more patients should be considered with caution. Defining protocols for additional patient selection criteria to reduce the numbers of patients who receive tocilizumab could be an alternative approach when anticipating shortages.
RkJQdWJsaXNoZXIy MTk4NDMw