scholarly journals 554. Early Clinical Outcomes with Tocilizumab for Covid-19: A Two-Center Retrospective Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S342-S343
Author(s):  
Steven Smoke ◽  
Karan Raja ◽  
Patrick Hilden ◽  
Nicole Daniel
Keyword(s):  
Clinical Improvement ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Univariate Analysis ◽  
Supplemental Oxygen ◽  
T Cell Therapy ◽  
Car T Cell Therapy ◽  
Car T ◽  
Study Sites ◽  
Early Clinical Outcomes

Abstract Background Severe Covid-19 is associated with elevated inflammatory markers, consistent with cytokine release syndrome (CRS). Tocilizumab is an IL-6 inhibitor, effective in treating CRS secondary to CAR-T cell therapy. The efficacy of tocilizumab in treating Covid-19 is unknown. Methods This was a retrospective cohort study conducted at two hospitals in northern New Jersey. All patients treated with tocilizumab for confirmed or suspected Covid-19 between the dates of 3/10/20 and 4/9/20 at the study sites were included. The primary endpoint was clinical improvement on day 7 after treatment as assessed by respiratory status. Univariate analysis compared data between those who improved and those who did not. Results Forty five severe and critically ill patients treated with tocilizumab for Covid-19 were evaluated. Eleven (24%), 22 (49%) and 12 (27%) patients improved, had no change and worsened by day 7 after treatment, respectively. Lower WBC and LDH at the time of drug administration as well as shorter time from supplemental oxygen initiation to dose were significantly associated with clinical improvement in the univariate analysis. Conclusion Tocilizumab administration was associated with a low rate of clinical improvement within 7 days in this cohort of severe and critically ill patients with Covid-19. Disclosures All Authors: No reported disclosures

118: RESOURCE UTILIZATION IN THE ICU IN CRITICALLY ILL PATIENTS FOLLOWING CAR T CELL THERAPY

2020 ◽  
Vol 48 (1) ◽  
pp. 42-42 ◽  
Author(s):  
Anne Rain Brown ◽  
Irfan Jindani ◽  
Judd Melancon ◽  
Rose Erfe ◽  
Lei Feng ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Therapy ◽  
Critically Ill ◽  
Resource Utilization ◽  
Critically Ill Patients ◽  
T Cell Therapy ◽  
Car T Cell ◽  
Car T Cell Therapy ◽  
Car T

scholarly journals 553. Critically Ill patients Receiving Tocilizumab Compared With Those Not Receiving Tocilizumab for Treatment of COVID-19

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S342-S342
Author(s):  
Michael Leonard ◽  
anthony Asher ◽  
Banks Kooken ◽  
Erin Donahue ◽  
james Symanowski ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Critically Ill ◽  
Symptom Onset ◽  
Critically Ill Patients ◽  
Immune Modulation ◽  
Case Series ◽  
Supplemental Oxygen ◽  
Retrospective Case ◽  
Protein Levels ◽  
The Impact

Abstract Background Background:: Immune modulation in patients with clinical features suggestive of a cytokine release syndrome (CRS) has become a pharmacologic target for potential treatment of COVID-19 and prevention of ARDS. Tocilizumab is an IL-6 receptor blocker FDA-approved for chimeric antigen receptor (CAR) T cell-induced severe or life-threatening CRS. The objective of this study was to describe clinical outcomes associated with tocilizumab compared with those not receiving tocilizumab in critically ill patients with severe COVID-19. Methods Methods: Retrospective case series of 49 adult patients admitted to an intensive care unit with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients receiving tocilizumab were compared with those not receiving tocilizumab. The primary outcome was clinical improvement (decrease in supplemental oxygen requirement, discharge from ICU, or live discharge from hospital). Secondary endpoints included mortality and frequency of extubation. All comparative endpoints were assessed at 2 weeks after ICU admission. Results Results: 49 patients were identified with SARS-CoV-2 who were admitted to an ICU, 16 received tocilizumab. Baseline characteristics were similar; most were African American males with comorbidities such as obesity, cardiovascular disease, and diabetes. The time from symptom onset to positive test and subsequent intubation were similar (4 and 7 days, respectively). 75% received one dose (all received 8 mg/kg). The median time from symptom onset to tocilizumab administration was 11 days. In patients receiving tocilizumab compared with those not receiving tocilizumab, there were similar rates of clinical improvement (44% versus 61%, p=0.27), extubation (31% versus 45%, p=0.60), and mortality (18% versus 19%, p >0.99, respectively). 81% of the tocilizumab group had resolution of fever and 75% had improvement in C-reactive protein levels. Conclusion Conclusion: In this study of patients with progressed disease, outcomes were similar regardless of receipt of tocilizumab. Randomized controlled trials are needed to assess the impact of earlier administration and identify clinical characteristics to assist with selection of appropriate patients who may benefit from tocilizumab. Disclosures All Authors: No reported disclosures

Challenges and optimization of CAR-T cell therapy

2021 ◽  
Author(s):  
Mei Luo ◽  
Hongchang Zhang ◽  
Linnan Zhu ◽  
Qumiao Xu ◽  
Qianqian Gao
Keyword(s):  
T Cell ◽  
Cell Therapy ◽  
T Cell Therapy ◽  
Car T Cell ◽  
Car T Cell Therapy ◽  
Car T
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