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Response to: ’Correspondence on ‘Historically controlled comparison of glucocorticoids with or without tocilizumab versus supportive care only in patients with COVID-19-associated cytokine storm syndrome: results of the CHIC study’’ by Charles
  1. Sofia Ramiro1,2,
  2. Rémy L M Mostard3,
  3. Robert B M Landewé1,4
  1. 1Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands
  2. 2Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
  3. 3Department of Pulmonology, Zuyderland Medical Center, Heerlen, The Netherlands
  4. 4Amsterdam Rheumatology Center, AMC, Amsterdam, The Netherlands
  1. Correspondence to Dr Sofia Ramiro, Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands; sofiaramiro{at}

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We read the letter from Charles1 2 regarding our CHIC (COVID High-intensity Immunosuppression in Cytokine storm syndrome) study.3 Charles1 clearly expresses his disappointment in the methodology chosen for our study (a quasi-experimental study with a matched historical control group) and in the positive results of our immunosuppressive strategy. Charles claims that it is disappointing to see false positive results of tocilizumab while subsequent studies have shown negative results.

We certainly respect an opinion that differs from ours, but we take the liberty to gently disagree with the bold statements made. First is the chosen methodology. Indeed, as we have acknowledged in our paper more than once, a randomised controlled trial (RCT) is in principle the preferred study design when assessing the efficacy and safety of a …

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  • Handling editor Josef S Smolen

  • Contributors SR drafted the response. All authors reviewed and approved the final response.

  • 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 Commissioned; internally peer reviewed.

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