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Switching to the anti-interleukin-6 receptor antibody tocilizumab in rheumatoid arthritis patients refractory to antitumor necrosis factor biologics
Modern Rheumatology, 10/08/09

Kawashiri S et al. – 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 were evaluated. Although physicians need to watch for infectious adverse events, these data indicate that TCZ is effective for treating RA patients refractory to TNF antagonists.

Methods

evaluated the short-term effects of IL-6 receptor antibody TCZ in 6 patients with RA who had been refractory to TNF antagonist therapy
All subjects were considered to be secondary nonresponders to TNF antagonists as decided by each physician

Results

Disease Activity Score of 28 Joints (DAS28) improved slowly by TCZ compared with TNF antagonist therapy, significantly decreased at 24 weeks
1 patient achieved DAS28 remission [DAS28–erythrocyte sedimentation rate (ESR) < 2.60, and 5 of 6 patients showed good or moderate clinical response
Change in clinical Disease Activity Index similar to that of the DAS28–ESR
Serum level of matrix metalloproteinase-3 (MMP-3), a marker for synovial overgrowth, also significantly decreased after treatment (518 ± 567 at baseline, 141 ± 90 ng/ml at 24 weeks)
1 patient discontinued TCZ because of tuberculous peritonitis

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