{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:25:11Z","timestamp":1777940711272,"version":"3.51.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Royal College of Physicians of Edinburgh"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tocilizumab, an interleukin-6 (IL-6) inhibitor, and bevacizumab, a vascular endothelial growth factor (VEGF) inhibitor, have been used in critically ill COVID-19 patients for cytokine storm. We performed a registry-based prospective study to compare the efficacy of these two drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Virologically confirmed hospitalised patients with severe COVID-19 who received either tocilizumab or bevacizumab have been included. Management details and outcomes were recorded. The primary outcome was in-hospital deaths and secondary outcomes were 30-day deaths, changes in oxygen requirement at 48\u2009h of drug administration and duration of intensive care unit stay. Descriptive statistics are reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      One thousand three hundred forty-five COVID-19 patients were hospitalised during the study period, 87 with severe COVID-19 received tocilizumab (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200962) or bevacizumab (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200925). Patients in the tocilizumab group were older (62.6\u2009\u00b1\u200911 vs 53.2\u2009\u00b1\u200914,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001) with more cardiovascular disease and no significant differences in clinical features, laboratory investigations, or radiological and biochemical markers of disease severity. Oxygenation, ventilatory support and proning were similar as were supportive therapies (steroids, remdesivir, anticoagulants;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05). In-hospital deaths in tocilizumab vs bevacizumab group were 47 (75.8%) vs 12 (48.0%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.012) with unadjusted hazard ratio (HR) 1.91 (95% confidence interval (CI) 0.99\u20133.65,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.050) and age-adjusted HR 1.76 (95% CI 0.90\u20133.44,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.097). Secondary outcome of 30-day death was also more in tocilizumab group: 49 (79.0%) vs 13 (52.0%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.011). Within-group comparison showed that PaO\n                      <jats:sub>2<\/jats:sub>\n                      :FiO\n                      <jats:sub>2<\/jats:sub>\n                      at 48-h of drug administration was better in bevacizumab group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003) compared to tocilizumab (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.651).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>VEGF inhibitor bevacizumab led to significantly better ventilatory outcomes and lower in-hospital and 30-day deaths compared to IL-6 inhibitor tocilizumab in severely ill COVID-19 patients. Randomised studies are required to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14782715251394935","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T06:58:14Z","timestamp":1763017094000},"page":"271-277","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Tocilizumab vs bevacizumab in critically ill COVID-19 patients: Registry-based prospective study"],"prefix":"10.1177","volume":"55","author":[{"given":"Yatendra Kumar","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Critical Care, Eternal Heart Care Centre &amp; Research Institute, Eternal Hospital, Jaipur, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raghubir S","family":"Khedar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Eternal Heart Care Centre &amp; Research Institute, Eternal Hospital, Jaipur, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gulam Mateen","family":"Parihar","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Eternal Heart Care Centre &amp; Research Institute, Eternal Hospital, Jaipur, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil Kumar","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Eternal Heart Care Centre &amp; Research Institute, Eternal Hospital, Jaipur, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pramod","family":"Sarwa","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Eternal Heart Care Centre &amp; Research Institute, Eternal Hospital, Jaipur, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8356-3137","authenticated-orcid":false,"given":"Rajeev","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Medicine, Eternal Heart Care Centre &amp; Research Institute, Eternal Hospital, Jaipur, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"e_1_3_2_2_2","article-title":"COVID-19 trajectories among 57 million adults in England: a cohort study using electronic health records","volume":"4","author":"Thygesen JH","year":"2022","unstructured":"Thygesen JH, Tomlinson C, Hollongs S, et al. 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