Suministro controlado de tocilizumab durante la pandemia de COVID-19 e influencia sobre el tratamiento de pacientes reumatológicos

Background: Intravenous (IV) tocilizumab has been used to stop the inflammatory phase of SARS-CoV-2 infection. To preserve the largest number of IV units for this use, the Spanish Agency for Medicines and Health Products (AEMPS) carried out a controlled supply of it and recommended the change to a s...

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Veröffentlicht in:Revista española de salud pública 2021 (95)
Hauptverfasser: García Muñoz, Carmen, Ortiz Pérez, Sara, Lozano Morillo, Fernando, Herraiz Robles, Paola, Ferrari Piquero, José Miguel, Caro Teller, José Manuel, Pablos Alvarez, José Luis
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Zusammenfassung:Background: Intravenous (IV) tocilizumab has been used to stop the inflammatory phase of SARS-CoV-2 infection. To preserve the largest number of IV units for this use, the Spanish Agency for Medicines and Health Products (AEMPS) carried out a controlled supply of it and recommended the change to a subcutaneous presentation (SC) of tocilizumab or sarilumab in all those patients in IV tocilizumab treatment for rheumatologic indications. The objective of this study was to evaluate the change from IV tocilizumab to SC presentation due to its controlled supply during the COVID-19 pandemic. Methods: Retrospective observational study of adult patients (>18 years old) under treatment with IV tocilizumab follow-up by the Rheumatology Service of the Hospital 12 de Octubre. The follow- up period was 3 months (March 2020-June 2020) and 39 patients were included in the study. Variables related to the patients and their treatment were collected. A descriptive analysis of the data was carried out. Results: In 69.23% (n=27) of the patients, treatment was changed to SC tocilizumab (n=23) or sarilumab (n=4). 44% of patients (n=12) switched back to their original IV tocilizumab treatment. The reasons for stopping treatment with SC tocilizumab were: drug intolerance (n=4), disease worsening (n=4), and patient preference (n=1). Regarding sarilumab, the reasons were drug intolerance (n=2) and patient preference (n=1). Conclusions: Almost half of the patients had to return to the original treatment. The main reason was intolerance to the new treatment, followed by ineffectiveness and patient preferences. Fundamentos: El tocilizumab intravenoso (IV) ha sido empleado para frenar la fase inflamatoria de la infección por SARS-CoV-2. Para reservar el mayor número de unidades IV para este uso, la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) realizó una distribución controlada del mismo y recomendó el cambio a una presentación subcutánea (SC), fuera tocilizumab o sarilumab, en todos aquellos pacientes en tratamiento con tocilizumab IV para indicaciones reumatológicas. El objetivo de este trabajo fue evaluar el cambio de tocilizumab IV a una presentación SC debido a su suministro controlado durante la pandemia de COVID-19. Métodos: Se realizó un estudio observacional retrospectivo de pacientes adultos (mayores de 18 años) en tratamiento con tocilizumab IV en seguimiento por el Servicio de Reumatología del Hospital 12 de octubre (Madrid). El periodo de seguimiento fue
ISSN:1135-5727