抄録
Objective: To understand the safety profile and to develop experience in the administration of tocilizumab (TCZ) therapy in patients with elderly-onset rheumatoid arthritis (EORA). To estimate the effectiveness of tocilizumab therapy in EORA patients, we analyzed several parameters of inflammation, in addition to cytokines, and disease activity.
Methods: Twelve patients with EORA, all in their seventh decade of life, were administered tocilizumab therapy. Hematological and biological parameters were measured regularly. Rheumatoid arthritis disease activity was also measured by using the Disease Activity Score 28 and the Simple Disease Activity Index, respectively.
Results: Administration of tocilizumab rapidly decreased hematological parameters, especially C-reactive protein levels. The average patient baseline serum levels of interleukin-6 (IL-6) were initially elevated at 216.8 pg/ml (range 15.3-1,630 pg/ml), whereas in seven patients (58%) it decreased in last follow-up period. Three patients (25%) had increased baseline serum tumor necrosis factor-α levels compared to nine (75%) patients that did not have such elevations. Serum hemoglobin levels increased from an average of 11.4 g/dl prior to tocilizumab therapy to 12.8 g/dl after the commencement of therapy (p < 0.005). Three patients developed localized dermatological herpes zoster virus infections, but there were no severe complications in the follow-up period.
Conclusion: Tocilizumab therapy in patients with EORA was effective without severe side effects and IL-6 blockade may constitute a major therapy for this disease.
