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Is tocilizumab in combination with traditional DMARDs safe and effective for patients with active RA?

Nature Reviews Rheumatology volume 5, pages 128–129 (2009)Cite this article

Abstract

The interleukin 6 receptor antagonist tocilizumab was investigated in a 24-week, phase III randomized controlled trial for the treatment of active, DMARD-resistant rheumatoid arthritis (TOWARD study). The results indicated that the combination of tocilizumab with standard DMARDs produced a significantly higher clinical response rate than DMARDs alone, according to American College of Rheumatology and European League Against Rheumatism response criteria. Evaluation of adverse events revealed that tocilizumab had a good safety profile, although a slightly increased rate of infections, neutropenia, elevated liver enzyme levels and increased lipid levels were observed in some individuals. Further investigations will be required, however, to clarify which DMARD–tocilizumab combinations provide the best efficacy and safety profile in daily clinical practice and to exclude potential risks associated with long-term interleukin 6 blockade. In conclusion, the introduction of tocilizumab was shown to represent a safe and effective therapeutic approach for the treatment of rheumatoid arthritis refractory to treatment with DMARDs alone, which could substantially improve our treatment options for this condition.

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Authors and Affiliations

  1. E Feist is Head of the Clinical Trial Unit in the Department of Rheumatology and Clinical Immunology and G-R Burmester is Director of the Center of Internal Medicine and Dermatology at Charité–Universitätsmedizin Berlin, Germany.,

    Eugen Feist

  2. G-R Burmester is also Professor of Medicine in the Department of Rheumatology and Clinical Immunology at the Charité University Hospital, Free University and Humboldt University of Berlin, Germany.,

    Gerd-R Burmester

Authors
  1. Eugen Feist
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Correspondence to Gerd-R Burmester.

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Competing interests

E Feist has received speakers' honoraria from Abbott, Essex, Roche and Wyeth, and has received grant/research support from and been a consultant for Roche. G-R Burmester has received speakers' honoraria and grant/research support from and been a consultant for Abbott, Bristol-Myers Squibb, Essex, Roche and Wyeth.

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Feist, E., Burmester, GR. Is tocilizumab in combination with traditional DMARDs safe and effective for patients with active RA?. Nat Rev Rheumatol 5, 128–129 (2009). https://doi.org/10.1038/ncprheum1005

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