Tocilizumab for the treatment of rheumatoid arthritis

This study investigated if subcutaneous administration of tocilizumab is safe and effective in the long-term for the treatment of rheumatoid arthritis.

They found that subcutaneous tocilizumab was well tolerated and improved disease symptoms.

Rheumatoid arthritis (RA) is a chronic condition that features painful swelling of the joints. It is caused by an autoimmune reaction whereby cells in the body produce chemicals that cause excess inflammation. To treat RA patients are prescribed medication to reduce inflammation. These medications are called disease-modifying anti-rheumatic drugs (DMARDs).

Tocilizumab is a DMARD that targets interleukin-6, a chemical that promotes inflammation. Tocilizumab has been safely administered to patients intravenously (into the vein). Recently tocilizumab was developed in a form suitable for subcutaneous (under the skin) injection. Subcutaneous injection is an easier method of administration for patients and doctors.

This study investigated if subcutaneous tocilizumab is safe and effective in the long-term for the treatment of RA.

This study included 457 patients with RA that did not respond to other DMARDs. Patients were randomly assigned to two groups. One groups received subcutaneous tocilizumab (162 mg every 2 weeks) or placebo (substance with no active effect) for a 24-week period. At the end of week 24, all patients were assigned to receive tocilizumab (162 mg every 2 weeks) for a further 72 weeks. Patients were assessed using standard scoring systems for RA. These included the disease activity score (DAS28) and the American College of Rheumatology criteria (ACR). Higher scores indicate fewer symptoms.

Patients that received tocilizumab after placebo had improved ACR scores from 56% to 81%. Patients who continued on tocilizumab had an average score of 72%. DAS28 scores improved from 4% to 42% in patients that switched to tocilizumab from week 24 to week 96. Adverse event rates were low in both groups. Infections and injection site reactions were the most commonly reported adverse events. 

This study concluded that subcutaneous tocilizumab is well tolerated and improves disease symptoms up to 2 years.

The number of patients in this study was average. Larger studies will be performed to confirm the long-term safety of tocilizumab. 

If you have any questions regarding rheumatoid arthritis treatment please discuss with your physician.