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SISCO’) study. 1 The results from 30 patients treated with siltuximab in the ‘SISCO’ study compared with 30 matched controls, showed that treatment with siltuximab led to a 54% reduction in risk of 30-day all-cause mortality. 2 This pivotal study will evaluate the efficacy and safety of standard of care (SOC) with or without intravenous siltuximab in selected hospitalised patients with COVID-19 previously treated with corticosteroids or another respiratory virus infection. Unlike previous studies of agents targeting the interleukin-6 (IL-6) signalling pathway, the ‘SILVAR’ study has been rationally designed to only enrol those hospitalised patients suffering from serious viral acute respiratory distress syndrome (ARDS) in a hyperinflammatory state that will most likely benefit from the addition of an anti-IL-6 immunomodulator such as siltuximab. ....