Subcutaneous Tocilizumab May Be Effective in Refractory Fibromyalgia Patients

Tang, Kuo‐Tung; Liao, Tsai‐Ling; Chen, Yi Hsing; Chen, Der‐Yuan; Lai, Kuo-Lung

doi:10.3390/biomedicines11071774

Cited by 3 publications

(1 citation statement)

References 22 publications

(27 reference statements)

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“…In addition, many cytokines identified in patients’ serum with FM, such as IL-6, IL-8, and TNF-α, are produced by neutrophils [ 54 , 55 ]. In this regard, it was reported in one study that inhibition of IL-6 activity by the monoclonal antibody tocilizumab was able to reduce pain in patients with FM [ 56 ]. Although neutrophils are not normally present in the central nervous system, they can reach this anatomical site under pathological conditions, as demonstrated in animal models [ 57 , 58 ].…”

Section: The Innate Immune Systemmentioning

confidence: 99%

Inflammation, Autoimmunity, and Infection in Fibromyalgia: A Narrative Review

Paroli,

Gioia,

Accapezzato

et al. 2024

IJMS

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Fibromyalgia (FM) is a chronic disease characterized by widespread musculoskeletal pain of unknown etiology. The condition is commonly associated with other symptoms, including fatigue, sleep disturbances, cognitive impairment, and depression. For this reason, FM is also referred to as FM syndrome. The nature of the pain is defined as nociplastic according to the latest international classification and is characterized by altered nervous sensitization both centrally and peripherally. Psychosocial conditions have traditionally been considered critical in the genesis of FM. However, recent studies in animal models and humans have provided new evidence in favor of an inflammatory and/or autoimmune pathogenesis. In support of this hypothesis are epidemiological data of an increased female prevalence, similar to that of autoimmune diseases, and the frequent association with immune-mediated inflammatory disorders. In addition, the observation of an increased incidence of this condition during long COVID revived the hypothesis of an infectious pathogenesis. This narrative review will, therefore, discuss the evidence supporting the immune-mediated pathogenesis of FM in light of the most current data available in the literature.

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Section: The Innate Immune Systemmentioning

confidence: 99%

Inflammation, Autoimmunity, and Infection in Fibromyalgia: A Narrative Review

Paroli,

Gioia,

Accapezzato

et al. 2024

IJMS

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How to Distinguish Non-Inflammatory from Inflammatory Pain in RA?

Khot,

Tackley,

Choy

2024

Curr Rheumatol Rep

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Purpose of the Review Managing non-inflammatory pain in rheumatoid arthritis (RA) can be a huge burden for the rheumatologist. Pain that persists despite optimal RA treatment is extremely challenging for patient and physician alike. Here, we outline the latest research relevant to distinguishing non-inflammatory from inflammatory RA pain and review the current understanding of its neurobiology and management. Recent Findings Nociplastic pain is a recently introduced term by the international pain community. Its definition encompasses the non-inflammatory pain of RA and describes pain that is not driven by inflamed joints or compromised nerves, but that is instead driven by a functional reorganisation of the central nervous system (CNS). Summary Insights from all areas of nociplastic pain research, including fibromyalgia, support a personalised pain management approach for non-inflammatory pain of RA, with evidence-based guidelines favouring use of non-pharmacological interventions. Future developments include novel CNS targeting pharmacotherapeutic approaches to treat nociplastic pain.

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Assessing the Impact of IL-6 and Serotonin on Pain and Symptomatology in Fibromyalgia: An Exploratory Clinical Study

Loçasso,

Filho,

Alvarenga

et al. 2024

JPM

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Background and Objectives: Fibromyalgia (FM) is a chronic musculoskeletal pain syndrome characterized by widespread pain and a variety of other symptoms, including fatigue, cognitive dysfunction, and sleep disturbances. Recent research has highlighted the potential role of pro-inflammatory cytokines and neurotransmitters in the pathophysiology of FM. This study aimed to investigate the relationship between serum levels of interleukin-6 (IL-6) and serotonin with the clinical parameters observed in patients with fibromyalgia. Additionally, it sought to analyze the similarities and differences among the different groups classified by symptom severity. Materials and Methods: This cross-sectional study included 26 female patients aged 20–70 diagnosed with FM according to the American College of Rheumatology (ACR) 2016 criteria and 14 healthy controls (HCs). Serum levels of IL-6 and serotonin were measured using electrochemiluminescence and high-performance liquid chromatography (HPLC), respectively. Results: FM patients exhibited significantly higher pain scores (VAS), anxiety, and depression levels compared to HCs. FIQ-R scores were significantly elevated in FM patients, with stratification showing 3.8% mild, 65.4% moderate, 23.1% severe, and 7.7% very severe cases. While no significant difference in IL-6 levels was observed between the FM patients and HCs, a trend towards increased IL-6 levels in patients with higher FIQ-R scores was noted. Serum serotonin levels were significantly lower in the FM patients than in the HCs, with moderate patients having lower levels than those classified as severe and very severe. Conclusions: The study underscores the potential role of IL-6 and serotonin in the pathophysiology of FM, suggesting that these biomarkers could be relevant in assessing the severity and impact of FM. Further research is needed to elucidate these relationships and their implications for developing personalized treatment strategies.

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Subcutaneous Tocilizumab May Be Effective in Refractory Fibromyalgia Patients

Cited by 3 publications

References 22 publications

Inflammation, Autoimmunity, and Infection in Fibromyalgia: A Narrative Review

Inflammation, Autoimmunity, and Infection in Fibromyalgia: A Narrative Review

How to Distinguish Non-Inflammatory from Inflammatory Pain in RA?

Assessing the Impact of IL-6 and Serotonin on Pain and Symptomatology in Fibromyalgia: An Exploratory Clinical Study

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