How is tocilizumab administered in patients with rheumatoid arthritis (RA)?

Updated: Aug 22, 2019
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Tocilizumab, an IL-6 receptor inhibitor, is available as either an IV infusion or SC injection. It is indicated for moderate-to-severe active RA in adults who have had an inadequate response to 1 or more TNF-antagonist therapies. It may be used either alone or in combination with MTX or other DMARDs. However, Dougados et al found that in patients with active RA, combination therapy with IV tocilizumab and MTX did not yield better clinical results than tocilizumab monotherapy and that was more often associated with transaminase increases. [114]

In patients with inadequate response to TNF inhibitors, tocilizumab treatment results in significant, clinically meaningful, rapid, and sustained improvements in a number of patient-reported outcomes. [115, 116] A 2012 consensus statement confirmed the efficacy and safety of IL-6 pathway blockade in adult rheumatoid arthritis. [117]

In October 2013, the FDA approved an SC injection of tocilizumab that can be self-administered after proper training. The SC formulation has been shown to be as effective as the IV infusion and has the same safety profile except for increased injection site reactions with SC administration. [116]


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