Study on the safety and efficacy of tocilizumab, an anti-IL-6 receptor antibody, in patients with rheumatoid arthritis complicated with AA amyloidosis.

Abstract

OBJECTIVES:

Although treatment of rheumatoid arthritis (RA) has progressed by the use of biologics, amyloid A (AA) amyloidosis is still an intractable complication in patients with RA. In the present study, safety and efficacy of 1-year treatment with an anti-IL-6 receptor antibody tocilizumab (TCZ) on RA and AA amyloidosis were estimated.

METHODS:

TCZ (8 mg/kg every 4 weeks) was administered to five RA patients complicated with AA amyloidosis. The primary end point was improvement in renal dysfunction and the secondary end point was CDAI at 1 year after the treatment.

RESULTS:

An improvement in the renal dysfunction, including urinary protein secretion, was found, in four patients including two patients who were refractory to etanercept, with a remarkable decrease of SAA concentration, and the progression of organ dysfunction was prevented at 1 year in all patients treated with TCZ. The mean clinical disease activity index decreased from 33.9 to 4.7 (p = 0.012) in five patients treated with TCZ for 1 year. Three non-serious adverse events were observed in two patients.

CONCLUSIONS:

TCZ ameliorates renal dysfunction in RA patients complicated with AA amyloidosis who are refractory to conventional therapies, thereby suggesting that TCZ has a potential to regulate AA amyloidosis.

• Authors: Ippei Miyagawa, Shingo Nakayamada, Kazuyoshi Saito, Kentaro Hanami, Masao Nawata, Norifumi Sawamukai, Kazuhisa Nakano, Kunihiro Yamaoka, Yoshiya Tanaka
• Journal: Modern rheumatology (Mod Rheumatol) Vol. 24 Issue 3 Pg. 405-9 (May 2014) ISSN: 1439-7609 [Electronic] England
• PMID: 24252016 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents
• Receptors, Interleukin-6
• Serum Amyloid A Protein
• interleukin-6 receptor alpha
• tocilizumab

Topics

• Adult
• Aged
• Amyloidosis (complications, drug therapy)
• Antibodies, Monoclonal, Humanized (adverse effects, therapeutic use)
• Antirheumatic Agents (adverse effects, therapeutic use)
• Arthritis, Rheumatoid (complications, drug therapy)
• Disease Progression
• Female
• Humans
• Receptors, Interleukin-6 (antagonists & inhibitors)
• Serum Amyloid A Protein (analysis)
• Treatment Outcome