Immunotherapy of Tocilizumab for Rheumatoid Arthritis

Toshio Tanaka

doi:10.4172/2155-9899.s6-001

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease, characterized by persistent joint inflammation, systemic inflammation and immunological abnormalities. Because IL-6 plays a major role in the development of these characteristics, IL-6 blockade may reasonably be expected to constitute a novel therapeutic strategy for the treatment of RA. Phase III clinical trials of a humanized anti-human IL-6 receptor monoclonal antibody, tocilizumab, have demonstrated its outstanding clinical efficacy, either as monotherapy or in combination with disease-modifying antirheumatic drugs, for moderate to severe active RA patients. Although tocilizumab is currently recommended as a second-line biologic for RA patients whose response to one or more of TNF inhibitors is inadequate, further clinical studies including head-to-head comparative studies, and clarification of the mechanisms through which tocilizumab exerts its clinical effects are sure to identify RA patients who should be treated with tocilizumab as a first line biologic.

Highlights

Rheumatoid arthritis (RA), a chronic disease affecting 0.5-1% of adults, is characterized by persistent synovitis, systemic inflammation and immunological abnormalities
When Interleukin 6 (IL-6) acts on hepatocytes, it induces a broad spectrum of acute-phase proteins including C-reactive protein (CRP), serum amyloid A (SAA), haptoglobulin, antichymotrypsin, fibrinogen, and hepcidin, whereas it reduces the production of albumin, fibronectin, transferrin, and cytochrome p450 [10,11]
In the Collageninduced arthritis (CIA) model, IL-6 has been shown to perform a major role in the development and progression of joint destruction because IL-6 gene deficiency or IL-6 blockade by means of anti-IL-6 receptor antibody reduces the incidence and severity of arthritis [22,23,24]

Summary

Introduction

Rheumatoid arthritis (RA), a chronic disease affecting 0.5-1% of adults, is characterized by persistent synovitis, systemic inflammation and immunological abnormalities. At week 12, ACR20 response was observed in 78%, 57% and 11% of RA patients treated with tocilizumab 8, 4mg/kg and in the control groups, respectively.

Results

Conclusion