Evidence map›Paper›PMID 42140959›Full record

ArticleNature communications2026

Tocilizumab versus sarilumab among adults hospitalised with COVID-19: target trial emulation across England and Scotland.

Bang Zheng, Amanj Kurdi, Alain Amstutz, Amelia Green, Emily Herrett, John Tazare, Qing Wen, Viyaasan Mahalingasivam, Rebecca Smith, Brian MacKenna and 7 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Bang Zheng *Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China.ORCID http://orcid.org/0000-0003-1814-6692
Amanj Kurdi *Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.ORCID http://orcid.org/0000-0001-5036-1988
Alain Amstutz *Electronic Health Records Group, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Amelia GreenNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Emily HerrettDepartment of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
John TazareDepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
Qing WenDepartment of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0003-4325-7829
Viyaasan MahalingasivamDepartment of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Rebecca SmithNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Brian MacKennaNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Amir MehrkarNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-2098-1278
Seb BaconNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Ben GoldacreNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Chris RobertsonDepartment of Mathematics and Statistics, University of Strathclyde, Glasgow, UK.ORCID http://orcid.org/0000-0001-6848-5241
Sir Aziz SheikhNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. aziz.sheikh@phc.ox.ac.uk.ORCID http://orcid.org/0000-0001-7022-3056
Laurie TomlinsonDepartment of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. Laurie.Tomlinson@lshtm.ac.uk.ORCID http://orcid.org/0000-0001-8848-9493
OpenSAFELY Collaborative

Funding

Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (Swiss National Science Foundation) P500PM_221961Wellcome Trust
6 · The paper itself

Abstract

The interleukin-6 (IL-6) inhibitors tocilizumab and sarilumab have been repurposed for COVID-19 treatment. However, discrepancies exist across global and national COVID-19 guidelines, with limited data on the comparative effectiveness between these therapeutics especially during the delta/omicron periods. With the approval of NHS England and Public Health Scotland, we compared their effectiveness among adults hospitalised with COVID-19 using electronic health records data through the OpenSAFELY-TPP (England) and EAVE II (Scotland) platforms. Following the target trial emulation framework, 10,487 patients treated between July 2021 and February 2022, when both drugs were frequently prescribed, were included. In England, 1150 (20.1%) of 5710 participants receiving tocilizumab died by day 28 compared with 820 (20.4%) of 4025 participants receiving sarilumab (adjusted hazard ratio [aHR] 1.07, 95% CI 0.96-1.19). In Scotland, 114 (29.4%) of 388 participants receiving tocilizumab died by day 28 compared with 97 (27.0%) of 359 participants receiving sarilumab (aHR 0.92, 95% CI 0.68-1.23). There was no evidence of a difference in time to hospital discharge between the groups, and no credible effect modification by variant of concern, vaccination status, age, sex, ethnicity, body mass index, or comorbidities. Our findings provide supportive evidence for both drugs as alternative therapeutic options in COVID-19 in-patient management.

Indexed as

Antibodies, Monoclonal, HumanizedCOVID-19 Drug TreatmentAdultAgedCOVID-19EnglandFemaleHospitalizationHumansMaleMiddle AgedSARS-CoV-2ScotlandTreatment OutcomeAntibodies, Monoclonal, Humanizedsarilumabtocilizumab

Identifiers

PMID42140959
PMCPMC13376390

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.