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Drug information (i. Anti-infectives, ii. cytostatics, iii. others)
Efficacy and safety of tocilizumab in rheumatoid arthritis
  1. M.C. Gomez Blasco,
  2. E. Vicente Escrig,
  3. I. Martinez Martinez,
  4. B. Rodriguez Carballo,
  5. P. Jolonch Santasusagna
  1. 1Hospital Del Vendrell, Pharmacy, Tarragona, Spain

Abstract

Background A novel target for the treatment of rheumatoid arthritis (RA) is cytokine interleukin-6 (IL-6), a key pro-inflammatory cytokine in RA contributing to both the articular and systemic manifestations of the disease.

Purpose To describe the efficacy and safety of tocilizumab, an IL-6 receptor antibody, in RA.

Materials and methods Retrospective review of all patients treated with tocilizumab since its market launch between November 2009 and April 2011 in a regional hospital. Data collected from the management system software were: age, sex, treatment duration, previous treatments with biologicals, acute phase reactants (erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)), laboratory findings and adverse events.

Results 12 patients (10 women, 2 men) were included. Mean age was 52 years (range 35 – 69). Mean treatment duration was 8 months (range 2-18). 10 patients had previously been treated with biotherapy (4 adalimumab, 2 etanercept, 1 adalimumab and abatacept, and 3 patients with 3 biologicals). Evolution of median acute phase reactants as efficacy end points was:

ESR 62.5% reduction (from 32 mm/h at the beginning of treatment to 12 mm/h at the end of the study). CRP: 86% reduction (from 12.6 mg/L to 1.8 mg/L). Hepatic transaminases, lipid parameters and neutrophils were normal. 4 of 12 patients discontinued tocilizumab treatment (1 for lack of efficacy, 2 for adverse events and 1 for another reason). Adverse events were facial hyperaemia and dysaesthesias in arm and fingers.

Conclusions In this study tocilizumab showed a positive benefit-risk ratio in RA.

Major limitations were low number of patients and lack of long term safety data.

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