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I read with great interest the paper by Della Torre et al on the effects of sarilumab in severe acute respiratory syndrome coronavirus 2 severe-critical pneumonia. They show that sarilumab treated and standard of care (SOC) treated patients present a mortality rate which is statistically not different (n 28 SARI=7% vs n 28 SOC=18%; p=NS).1 These data confirm previous data from the same group; when analysing patients treated with tocilizumab, they showed no statistically significant differences (n 33 SOC=33%, mortality vs tocilizumab (TOCI) n 32=16%, p=NS).2 These data seem to suggest that interleukin (IL)-6 is not the main target. Indeed out of more than 20 studies reported so far in the literature, only half reported clinically significant results (paper submitted). The various studies have so many bias and differences that a definite conclusion is impossible. However, since the approach with biologics has a strong rationale in controlling the …
Contributors GF: substantial contribution to study conception and design; substantial contribution to analysis and interpretation of data; drafted the paper for its intellectual content; finally approved the version fo the submitted article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; internally peer reviewed.