Interim Position Statement: Interleukin-6 inhibitors (tocilizumab or sarilumab) for patients admitted to ICU with COVID-19 pneumonia (adults)

The REMAP-CAP platform trial has reported survival and time to recovery benefits for tocilizumab or sarilumab. Clinicians should consider prescribing IV tocilizumab (sarilumab an alternative if available) following the criteria defined in this interim position statement.

SPS commentary:

Emerging data from immune modulation arm of the REMAP-CAP trial indicate sizeable positive benefits with the use of tocilizumab or sarilumab in patients admitted to an ICU, with mortality reported as 27% versus 35.8% in the placebo group. The effect is thought to be supplementary to those from corticosteroids (used in 80% of patients). 

Work is now underway to develop a UK clinical commissioning policy for tocilizumab and sarilumab, which will be based on a NICE review of the available research evidence.  The policy will replace the Interim Position Statement.

An accompanying therapeutic alert lists the immediate steps that NHS acute trusts/ health boards are asked to take to support treatment of patients admitted to intensive care with COVID-19.


Medicines and Healthcare products Regulatory Agency