Épisode 41 : Étude RECOVERY, volet tocilizumab

Diffusé le 19 mai 2021

Dans cette 41e baladodiffusion, les Drs Luc Lanthier et Michaël Mayette discutent de l’efficacité du tocilizumab dans le traitement des patients hospitalisés pour la COVID-19, en plus de réviser la littérature médicale de mars et avril 2021.

Quiz clinique (3 min 26), étude principale (4 min 30), critique (20 min 38), autres articles (29 min 00), réponse au quiz clinique (34 min 03).

Référence principale

RECOVERY Collaborative Group. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2021;397(10285):1637-1645. PMID: 33933206.

Infographie

Article résumé

Lanthier L, Mayette M, Plourde MÉ, Cauchon M. Chez les sujets hospitalisés pour COVID-19 avec hypoxémie et inflammation systémique, est-ce que le tocilizumab diminue la mortalité à 28 jours comparativement au traitement standard tout en étant sécuritaire ? Rev Med Interne. (à paraître)

Articles associés

Fajgenbaum DC, June CH. Cytokine Storm. N Engl J Med. 2020;383(23):2255-73. PubMed PMID: 33264547.

https://www.covid19treatmentguidelines.nih.gov/whats-new/

https://www.inesss.qc.ca/covid-19/traitements-specifiques-a-la-covid-19/biotherapies-dirigees-contre-linterleukine-6-ou-son-recepteur-mise-a-jour-completee-10-08-2020.html

Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021;325(14):1414-25. PubMed PMID: 33755728.

Dagan N, Barda N, Kepten E, Miron O, Perchik S, Katz MA, et al. BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting. N Engl J Med. 2021;384(15):1412-23. PubMed PMID: 33626250.

Sadoff J, Gray G, Vandebosch A, Cardenas V, Shukarev G, Grinsztejn B, et al. Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19. N Engl J Med. 2021;384(23):2187-2201. PubMed PMID: 33882225.

Greinacher A, Thiele T, Warkentin TE, Weisser K, Kyrle PA, Eichinger S. Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination. N Engl J Med. 2021;384(22):2092-2101. PubMed PMID: 33835769.

Scully M, Singh D, Lown R, Poles A, Solomon T, Levi M, et al. Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination. N Engl J Med. 2021;384(23):2202-11. PubMed PMID: 33861525.

Samuel M, Tardif JC, Bouabdallaoui N, Khairy P, Dube MP, Blondeau L, et al. Colchicine for Secondary Prevention of Cardiovascular Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Can J Cardiol. 2021;37(5):776-85. PubMed PMID: 33075455.

Xia M, Yang X, Qian C. Meta-analysis Evaluating the Utility of Colchicine in Secondary Prevention of Coronary Artery Disease. Am J Cardiol. 2021;140:33-8. PubMed PMID: 33137319.

Berg DD, Jhund PS, Docherty KF, et al. Time to Clinical Benefit of Dapagliflozin and Significance of Prior Heart Failure Hospitalization in Patients With Heart Failure With Reduced Ejection Fraction. JAMA Cardiol. 2021;6(5):499-507. PubMed  PMID: 33595593.

McMurray JJV, Packer M. How Should We Sequence the Treatments for Heart Failure and a Reduced Ejection Fraction?: A Redefinition of Evidence-Based Medicine. Circulation. 2021;143(9):875-877. PubMedPMID: 33378214.

Autres articles d'intérêt récents

Newsome PN, Buchholtz K, Cusi K, Linder M, Okanoue T, Ratziu V, et al. A Placebo-Controlled Trial of Subcutaneous Semaglutide in Nonalcoholic Steatohepatitis. N Engl J Med. 2021;384(12):1113-24. PubMed PMID: 33185364.

Rastogi R, Sheehan MM, Hu B, Shaker V, Kojima L, Rothberg MB. Treatment and Outcomes of Inpatient Hypertension Among Adults With Noncardiac Admissions. JAMA Intern Med. 2021;181(3):345-52. PubMed PMID: 33369614.

Dinh A, Ropers J, Duran C, Davido B, Deconinck L, Matt M, et al. Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial. Lancet. 2021;397(10280):1195-203. PubMed PMID: 33773631.

Gaudry S, Hajage D, Martin-Lefevre L, Lebbah S, Louis G, Moschietto S, et al. Comparison of two delayed strategies for renal replacement therapy initiation for severe acute kidney injury (AKIKI 2): a multicentre, open-label, randomised, controlled trial. Lancet. 2021;397(10281):1293-300. PubMed PMID: 33812488.

The REMAP-CAP Investigators. Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19. N Engl J Med. 2021;384(16):1491-502. PubMed PMID: 33631065.

Guides de pratique

McDonald M, Virani S, Chan M, et al. CCS/CHFS Heart Failure Guidelines Update: Defining a New Pharmacologic Standard of Care for Heart Failure With Reduced Ejection Fraction. Can J Cardiol. 2021;37(4):531-546. PubMed PMID: 33827756.

Gupta S, Lieberman D, Anderson JC, et al. Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2020 Mar;115(3):415-434. PubMed PMID: 32039982.

Shoamanesh A, Patrice Lindsay M, Castellucci LA, et al. Canadian stroke best practice recommendations: Management of Spontaneous Intracerebral Hemorrhage, 7th Edition Update 2020. Int J Stroke. 2021;16(3):321-341. PubMed PMID: 33174815.

Collet JP, Thiele H, Barbato E, et al; ESC Scientific Document Group. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021;42(14):1289-1367. PubMed PMID: 32860058.

Références du quiz clinique

Dworeck C, Redfors B, Angerås O, et al. Association of Pretreatment With P2Y12 Receptor Antagonists Preceding Percutaneous Coronary Intervention in Non-ST-Segment Elevation Acute Coronary Syndromes With Outcomes. JAMA Netw Open. 2020;3(10):e2018735. PubMed  PMID: 33001202.