RE: Robustness of Significant Dichotomous Outcomes in Randomized Controlled Trials in the Treatment of P12 Jan 2023 22:21
immunostimulants, such as interferon and Mycobacterium vaccae, was the smallest and the evidence was the most fragile compared with immunosuppressants including nonspecific (hydroxychloroquine, glucocorticoid, colchicine) or specific ones (tofacitinib, bocilizumab). This could be explained by the immune features of the cytokine storm; in the early stage of the infection the secretion of interferon was delayed, whereas in the late stage, pro-inflammatory cytokines were excessively secreted [33]. Immunostimulants could be urgently needed in the early stage and immunosuppressants could work better in the late stage [34]. However, the RCTs that adopted immunostimulants were performed in the hospitalized patients, even some of them were severe cases at late stage [35,36,37,38,39]. The higher FI of specific immunosuppressants supported the judgment that new generation cytokine-targeted therapies, such as tofacitinib and tocilizumab, could be the most promising drugs [34].