Historically controlled comparison of glucocorticoids with or without tocilizumab versus supportive care only in patients with COVID-19-associated cytokine storm syndrome: results of the CHIC study

In this study, patients treated with a course of high-dose methylprednisolone plus tocilizumab escalation (days 2-5) if required were more likely to achieve improvement in respiratory status (HR 1.79; 95% CI 1.20-2.67) and on average 7 days earlier than historical controls.

SPS commentary:

This small study (86 patients per group) was conducted at the Zuyderland Medical Center in the Netherlands. All patients with COVID-19-associated cytokine storm syndrome were treated with the methylprednisolone with tocilizumab escalation protocol from 1st April 2020 and the controls consisted of matched patients admitted between 7 March and 31 March 2020, who did not receive this treatment. The authors also report that hospital mortality was lower (HR 0.35; 95% CI 0.19-0.65), as was requirement for mechanical ventilation (0.29; 95% CI 0.14-0.65; p=0.0003) for those who received the intensive treatment, when compared to the controls. They note that these initial results are promising, but further confirmation is needed.

Annals of the Rheumatic Diseases