Interleukin-6 inhibition for treatment of rheumatoid arthritis: A review of tocilizumab therapy

Abstract

The dawn of the biologic era has been an exciting period for clinical research and patient care in rheumatoid arthritis (RA). Targeted biologic therapies have changed the outcome of this disease and made remission a realistic outcome for many patients. Tocilizumab (TCZ, Actemra®), is a humanized monoclonal antibody against the interleukin 6 receptor and has been approved in many countries for the treatment of moderate to severe RA. There have been a number of important clinical trials demonstrating the efficacy of TCZ in active rheumatoid arthritis. This review summarizes the data on efficacy, patient-reported outcomes, adverse events, and safety from some of these trials. Current trends in clinical practice will be discussed. It is difficult to place TCZ and many new medications in the algorithm of treatment at present. However, the next few years will hopefully reveal their role as we better define abnormal immune processes in individuals with RA.

Immunohistochemical analysis of in vivo UVB-induced secretion of IL-1α and IL-6 in keratinocytes

“…It is secreted by keratinocytes and stimulates immune response in both normal and abnormal skin conditions (14). The anti-IL-6 antibody tocilizumab is reported to be effective for treating psoriasis, reumatoid arthritis and Castleman's disease (15).…”

Omega-3 polyunsaturated fatty acids in early undifferentiated peripheral arthritis

“…Выбор иммунологических показателей для оценки был обусловлен их патогенетическим значением для развития хронического персистирующего артрита. ИЛ 6 -один из наиболее важных провоспалительных цитокинов, важнейший медиатор ост-рой фазы воспаления, ассоциированный с локальным и си-стемным воспалительным процессом [27,28]. ФНО α -вне-клеточный белок, многофункциональный провоспалитель-ный цитокин, ассоциированный с активацией клеточного иммунитета, ангиогенезом, иммунопролиферацией, акти-вацией остеокластов [29].…”

Vaccination in Patients with Rheumatoid Arthritis Receiving Immunotherapies

“…Blocking IL-6 should therefore impair antibody production. Tocilizumab is a humanized monoclonal anti-IL-6 receptor antibody which has been shown to be effective in RA patients with moderate to severe RA who have demonstrated an insufficient response to methotrexate and one or more anti-TNF-α agents [52]. Little experience with vaccinations under treatment with tocilizumab exists from studies in children and young adults with systemic JIA.…”