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Is tocilizumab an option for the treatment of arthritis?

AbstractBACKGROUND:
Some patients with rheumatoid arthritis and systemic-onset juvenile idiopathic arthritis are resistant to inhibitors of interleukin-1 and tumour necrosis factor. Raised levels of interleukin-6 are associated with both these conditions. Tocilizumab is a humanised monoclonal antibody that binds to both forms of interleukin-6 receptor that has recently been used in Phase III trials in rheumatoid arthritis and systemic-onset juvenile idiopathic arthritis.
METHODS:
The study conducted an evaluation of Phase III trials with tocilizumab.
RESULTS:
In the Tocilizumab Pivotal Trial in Methotrexate Inadequate Responders the primary efficacy end-point was the proportion of subjects with a 20% improvement in their rheumatoid arthritis signs and symptoms according to the American College of Rheumatology criteria and, at 24 weeks, this value was 26% with placebo and was increased to 48 and 59% with tocilizumab at 4 and 8 mg respectively. In the trial of tocilizumab in systemic-onset juvenile idiopathic arthritis, the primary end-point in the open-label lead-in was the proportion of subjects achieving an American College of Rheumatology Pediatric 30 response and 91% of subjects had achieved this at 6 weeks. This response was maintained by the majority of subjects being treated with tocilizumab during a 12-week double-blind trial and 48 weeks of open trial follow-up. Small numbers of subjects developed infections in both studies.
CONCLUSIONS:
Provided long-term safety can be established, tocilizumab will probably become part of the treatment for rheumatoid arthritis and may become a major breakthrough for the treatment of systemic-onset juvenile idiopathic arthritis.
AuthorsSheila A Doggrell
JournalExpert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 9 Issue 11 Pg. 2009-13 (Aug 2008) ISSN: 1744-7666 [Electronic] England
PMID18627338 (Publication Type: Journal Article)
Chemical References
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • tocilizumab
Topics
  • Adult
  • Antibodies, Monoclonal (administration & dosage, adverse effects, therapeutic use)
  • Antibodies, Monoclonal, Humanized
  • Arthritis, Juvenile (drug therapy)
  • Arthritis, Rheumatoid (drug therapy)
  • Child
  • Clinical Trials, Phase III as Topic
  • Dose-Response Relationship, Drug
  • Humans

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