ANTI-IL-6 THERAPY IN SEPSIS: POTENTIAL ROLE OF TOCILIZUMAB IN CONTROLLING THE INFLAMMATORY RESPONSE

Abstract

Severe sepsis is a high-mortality condition characterized by a dysregulated inflammatory response and excessive release of pro-inflammatory cytokines, among which interleukin-6 (IL-6) plays a central role. In this context, tocilizumab, an anti-IL-6R monoclonal antibody, has been studied as an adjunctive strategy in the management of sepsis, aiming to modulate the inflammatory response and reduce organ dysfunction. This study aimed to analyze, through an integrative literature review, the impact of tocilizumab on sepsis, with an emphasis on its immunomodulatory effects and associated clinical outcomes. The search was conducted in April 2025 in the US National Library of Medicine (PubMed), Cochrane Library, MEDLINE, and Embase databases. The Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) were used, in combination with the Boolean operators AND and OR. Studies published between 2018 and 2025, in English, available in full, and addressing the use of tocilizumab in severe sepsis were included. After applying the eligibility criteria, six studies comprised the final sample: four clinical studies and two experimental studies in animal models. The results showed that tocilizumab promoted a reduction in inflammatory cytokines, improved hemodynamics, tissue preservation, and increased survival in different clinical and preclinical settings. It is concluded that IL-6 blockade with tocilizumab represents a promising alternative for the management of severe sepsis, although current evidence still lacks robust clinical trials to validate its efficacy and safety on a large scale.