Interim Position Statement: Tocilizumab for patients admitted to ICU with COVID-19 pneumonia (adults)

Following data from the REMAP-CAP trial, this position statement provides information to clinicians and healthcare organisations considering prescribing tocilizumab for COVID-19 pneumonia when the internal governance arrangements are in place.

SPS commentary:

Eligibility criteria under this position statement are:

  • Admitted to ICU with severe pneumonia requiring respiratory support, such as highflow nasal oxygen, continuous positive airway pressure (CPAP) or non-invasive ventilation, or invasive mechanical ventilation; and
  • COVID-19 infection is confirmed by microbiological testing or where a multidisciplinary team has a high level of confidence that the clinical and radiological features suggest that COVID-19 is the most likely diagnosis

Dosing and administration:

  • The recommended dose is 8mg/kg to be administered as an intravenous infusion.
  • The total dose should not exceed 800mg.
  • Tocilizumab should be diluted in a 100mL bag of 0.9% sodium chloride, after removing an equivalent volume of saline (total volume 100mL) and given over 1 hour.
  • A single dose is to be administered, with the option to repeat a dose in 12-24 hours after the initial dose if there has not been sufficient clinical improvement.

A therapeutic alert detailing steps organisations should take to implement this position statement has also been produced in conjunction.

Chief Medical Officer

Resource links:

Therapeutic alert