TY - JOUR AU - Zallocco, Nicoletta AU - Gasperoni, Lorenzo AU - Caraffa, Alessandro AU - Mancini, Mauro T1 - Off-label use of Tocilizumab in COVID-19 patients:
an innovate prescribing tool to support the access path to the drug PY - 2020 Y1 - 2020-07-01 DO - 10.1721/3442.34310 JO - Giornale Italiano di Farmacia Clinica JA - GIFAC VL - 34 IS - 3 SP - 123 EP - 128 PB - Il Pensiero Scientifico Editore SN - 1120-3749 Y2 - 2026/04/24 UR - http://dx.doi.org/10.1721/3442.34310 N2 - Summary. Introduction. Based on the Tocilizumab mechanism of action, it is hypothesized that treatment may be useful in patients with lung involvement secondary to SARS-CoV-2. During the COVID-19 emergency, the internal reorganization of an Italian Hospital led to reassign 255 beds of some operating units into 209 beds, dedicated to the COVID-19 patients. The off-label use of Tocilizumab began and the supplies of the drug were not such as to guarantee the potential needs. Pharmacy Unit needs to introduce a prescribing tool, to be shared and validated among the clinicians involved. A prescriptive tool was configured to equalize the right of access to Tocilizumab, to ensure immediate tracking of requests and to be strategically efficient at simplifying the procedures. Materials and methods. The tool is an online spreadsheet application that can create documents shared at the same time by multiple users with the possibility of inserting, calculating and storing data. The grid required the patient’s eligibility: age>18 years, informed consent, real-time PCR diagnosis of SARS-CoV-2 infection, hospitalization due to clinical/instrumental diagnosis, presence of acute respiratory distress syndrome, presence of exaggerated inflammatory response. To identify objective criteria of priority were considered: patient age and life expectancy based on comorbidities, the pneumonitis burden on CT, oxygen saturation and oxygen therapy in progress, days from the onset of symptoms and H-Score. Results. The prescriptive tool registered the request for 88 Tocilizumab therapies from March 30th to April 30th with an average of 4,5 therapies in the first 16 days and an average of 1 therapy in the remaining 16 days. The strategy of optimizing the available drug resource resulted in a percentage difference between the prescribed drug milligrams and the drug consumed milligrams of -7%. Conclusions. The prescriptive tool has proved to be useful and intuitive, allowing immediate use by the units authorized to its employment. ER -