IL-6 pathway inhibitor Tocilizumab injection to treat hospitalized COVID 19 patients in INDIA
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IL-6 pathway inhibitors tocilizumab to treat hospitalized covid 19 patients
Markedly elevated inflammatory markers (eg, D-dimer, ferritin) and elevated pro-inflammatory cytokines (including interleukin [IL]-6) are associated with critical and fatal COVID-19, and blocking the inflammatory pathway may prevent disease progression
Several agents that target the IL-6 pathway have been evaluated in randomized trials for treatment of COVID-19; these include the IL-6 receptor blockers tocilizumab and sarilumab and the direct IL-6 inhibitor siltuximab.
Tocilizumab is given as a drip (intravenous infusion) or as an injection directly into a vein.
You may be asked for regular blood tests to check blood counts, cholesterol level and liver functioning during the treatment.
It might make you feel dizzy. If this happens, avoid driving or operating on machinery.
It makes it hard to fight with an infection. Inform your doctor if you notice fever, cough or stomach pain.
Inform your doctor if you are pregnant, planning to become pregnant or are breastfeeding.
Do not stop taking medicine without talking to your doctor first.
Q. Who should be treated with Tocilizumab?
Tocilizumab should be given for treating patients suffering from moderate to severe Covid-19 infection who have persistent reduction in their oxygen levels (a condition called hypoxia) that continues to get worse. The hypoxia may continue to get worsened even after 24 to 48 hours of treatment with corticosteroids and supportive care.
Q. Is Tocilizumab recommended for all Covid-19 patients? If not, why?
No, Tocilizumab is not recommended for all Covid-19 patients. This is because Tocilizumab has its own potential health hazards. Tocilizumab can lead to persistent serious infection and prolonged multiplication and shedding of the virus causing infection, so, it must be given only if the benefits outweigh the risks involved.
Q. What are the side effects of Tocilizumab?
The potential side effects of Tocilizumab include anaphylaxis (serious allergic reaction) with infusion, transaminitis (very high levels of liver enzymes due to which they start moving into the bloodstream), leukopenia (a condition where a person has reduced white blood cells and hence increased risk for infections) and neutropenia (a condition where a person has abnormally low number of cells called neutrophils, that fight infections in our body). Some other side effects are risk of serious bacterial infections, viral infections and reactivation of tuberculosis (TB) virus.
Q. Who should not be given Tocilizumab?
Tocilizumab should be avoided in individuals with hypersensitivity to tocilizumab, uncontrolled serious infections other than COVID-19, absolute neutrophil count (ANC) less than 500 cells/microL, platelet counts less than 50K, alanine aminotransferase (ALT) greater than 5 times the upper limit of normal (ULN), and elevated risk for gastrointestinal perforation. The use of Tocilizumab is contraindicated in pregnancy and breastfeeding mothers too, owing to its risk of developing serious complications.
Q. What to do if there is no improvement seen after giving Tocilizumab too?
Your doctor will decide the next course of action if there is no improvement seen even after giving Tocilizumab. Tocilizumab will prevent inflammation of the lungs but will not cure the damage already done due to the existing disease. Recovery of the lungs takes time to improve. Persistent breathlessness after Tocilizumab administration requires further evaluation of patients for other lung-related issues (pulmonary intravascular coagulopathy) or heart-related problems (cardiac dysfunctions). Any other bacterial infections that might have occurred should also be treated separately.
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