Clinical Characteristics and Outcomes of Critically ill Mechanically Ventilated COVID-19 Patients Receiving interleukin-6 Receptor Antagonists and/or Corticosteroid Therapy, the INTERACT study: A Multicenter International Observational Study

https://www.medrxiv.org/content/10.1101/2021.04.12.21255323v1

NCT04486521- A total of 860 patients met eligibility criteria: 589 received steroids, 170 IL-6R antagonists, and 101 combination therapy, and the groups were balanced after adjustment.  The use of IL-6R antagonists alone or in combination was not associated with a significant difference in ventilator-free days (VFD) compared to steroids alone (adjusted incidence rate ratio [95% CI]): IL-6R antagonists (1.12 [0.88,1.4]), combination (0.83 [0.6,1.14]). Patients treated with low or high-dose steroids had non-significant differences in VFD compared to IL-6R antagonists (ß= 0.62, 95% CI −1.54, 2.78 for low-dose steroid; ß= −1.19, 95% CI −3.85, 1.47 for high-dose steroid). The use of IL-6R antagonists alone or in combination was not associated with a significant difference in 28-day mortality compared to steroids alone (adjusted odds ratio [95% CI]): IL-6R antagonists alone (0.68 [0.44,1.07]), combination (1.07 [0.67,1.7]). There was no difference in hospital mortality compared to steroids alone (aOR 0.68, 95% CI 0.43,1.09 for IL6-R antagonist, aOR 1.23, 95 % CI 0.72,2.11 for combination). We observed no difference in outcomes between mechanically ventilated adult ICU patients who received IL-6R antagonists, steroids, or combination therapy and those who received IL-6R antagonists or low- or high-dose steroids.

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