Immunotherapy of Tocilizumab for Rheumatoid Arthritis

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.