Safety and efficacy of tocilizumab for rheumatoid arthritis: a systematic review and metaanalysis of clinical trial studies

Abstract

The present systematic review and meta-analysis was conducted to assess the effect of tocilizumab (TCZ) in patients with rheumatoid arthritis (RA). We systematically searched all potential articles in the main databases, including PubMed, Scopus, EMBASE, Web of Sciences (ISI), and Cochrane Center. The search was subsequently updated in December 2020. The initial review and extraction of information were performed independently by two authors to collect the first author and publication year; sample size; mean age of the intervention and control groups; the dose of TCZ, and the follow-up duration. Outcomes of interest include the ACR20, ACR50, ACR70, total complication rate, and the occurrence of remission. Any disagreements between the reviewers were resolved by discussion and re-check of the article and consultation with a third reviewer. After reviewing and culling, 15 clinical trials comparing the clinical efficacy of TCZ and its comparators in the treatment of patients with RA entered the qualitative and quantitative synthesis. Tocilizumab 8 mg was statistically better than 4 mg or placebo for ACR responses. Significant clinical adverse events in patients with RA treated with TCZ, such as abnormal liver function tests (LFTs) and infections, were more frequent than in comparator groups. This systematic review and meta-analysis suggest that the combination therapy of TCZ with other drugs such as methotrexate and disease-modifying antirheumatic drugs has been studied for various clinical effects concerning safety and clinically significant adverse events. Although the data are promising, long-term performance and safety data need to be fully identified, as well as the risks and benefits of TCZ, especially appropriate timing, dosage, and regimen.

Efficacy and safety of tocilizumab in patients with refractory generalized myasthenia gravis

“…The reported AEs associated with tocilizumab in our study were consistent with its known safety profile in RA 36–38 . The long‐term safety profile of tocilizumab (mean treatment duration, 2.4 years) from several phase III trials and open‐label extensions did not demonstrate an increase in serious or treatment‐related AEs, and the data were overall consistent with those of post‐marketing trials and clinical experience 39 .…”

“…The reported AEs associated with tocilizumab in our study were consistent with its known safety profile in RA. [36][37][38] The long-term safety profile of tocilizumab (mean treatment duration,…”

Interplay of Tocilizumab in Critical COVID-19 Cases

“…The increased risk of infections, particularly serious or opportunistic infections, are one of the most significant risks associated with TCZ. Patients taking TCZ are, therefore, more susceptible to infections such as pneumonia, sepsis, and tuberculosis (16). Our data withal revealed that patients with comorbidities had worsened prognostic laboratory results.…”

Adipose-Derived Stem Cell Exosomes as a Novel Anti-Inflammatory Agent and the Current Therapeutic Targets for Rheumatoid Arthritis

“…Newer bDMARDs, with various modes of action, can be administered to RA patients who are unresponsive to TNF-inhibitor treatment [ 54 ]. For instance, abatacept (ABT, which interrupts the costimulation molecule signal between T and B cells) [ 55 ], rituximab (RTX, which targets CD20 + B cells) [ 56 ], and tocilizumab (TCZ, which is an IL-6 receptor (IL-6R) antagonist) [ 57 ] have demonstrated high treatment efficacy in patients with active RA, particularly in those with inadequate responses to TNF-inhibitor treatment [ 58 ].…”