RESEARCH - Switching to the IL-6 inhibitor tocilizumab in RA patients refractory to anti-TNF biologics

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Mod Rheumatol. 2009 Oct 3. Epub 2009 Oct 3.

Switching to the anti-interleukin-6 receptor antibody tocilizumab in

rheumatoid arthritis patients refractory to antitumor necrosis factor

biologics.

Kawashiri SY, Kawakami A, Iwamoto N, Fujikawa K, Aramaki T, Tamai M,

Arima K, Ichinose K, Kamachi M, Yamasaki S, Nakamura H, Origuchi T,

Ida H, Eguchi K.

Unit of Translational Medicine, Department of Immunology and

Rheumatology, Graduate School of Biomedical Sciences, Nagasaki

University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.

We evaluated the short-term effects of the anti-interleukin-6 (IL-6)

receptor antibody tocilizumab (TCZ) in six patients with rheumatoid

arthritis (RA) who had been refractory to tumor necrosis factor (TNF)

antagonist therapy. All subjects were considered to be secondary

nonresponders to TNF antagonists as decided by each physician. The

Disease Activity Score of 28 Joints (DAS28) appeared to improve slowly

by TCZ compared with TNF antagonist therapy, but significantly

decreased at 24 weeks. One patient achieved DAS28 remission

[DAS28-erythrocyte sedimentation rate (ESR) <2.60, and 5 of 6 patients

showed good or moderate clinical response. The change in the clinical

Disease Activity Index was similar to that of the DAS28-ESR. The serum

level of matrix metalloproteinase-3 (MMP-3), a marker for synovial

overgrowth, also significantly decreased after the treatment (518 +/-

567 at baseline, 141 +/- 90 ng/ml at 24 weeks, p < 0.05). One patient

discontinued TCZ because of tuberculous peritonitis. Although

physicians need to watch for infectious adverse events, these data

indicate that TCZ is effective for treating RA patients refractory to

TNF antagonists.

PMID: 19802651

http://preview.ncbi.nlm.nih.gov/pubmed/19802651

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