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Efficacy of the anti–IL-6 receptor antibody tocilizumab in neuromyelitis optica: A pilot study

OBJECTIVE: To evaluate the safety and efficacy of a humanized anti–interleukin-6 receptor antibody, tocilizumab (TCZ), in patients with neuromyelitis optica (NMO). METHODS: Seven patients with anti–aquaporin-4 antibody (AQP4-Ab)-positive NMO or NMO spectrum disorders were recruited on the basis of t...

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Detalles Bibliográficos
Autores principales: Araki, Manabu, Matsuoka, Takako, Miyamoto, Katsuichi, Kusunoki, Susumu, Okamoto, Tomoko, Murata, Miho, Miyake, Sachiko, Aranami, Toshimasa, Yamamura, Takashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4001188/
https://www.ncbi.nlm.nih.gov/pubmed/24634453
http://dx.doi.org/10.1212/WNL.0000000000000317
Descripción
Sumario:OBJECTIVE: To evaluate the safety and efficacy of a humanized anti–interleukin-6 receptor antibody, tocilizumab (TCZ), in patients with neuromyelitis optica (NMO). METHODS: Seven patients with anti–aquaporin-4 antibody (AQP4-Ab)-positive NMO or NMO spectrum disorders were recruited on the basis of their limited responsiveness to their current treatment. They were given a monthly injection of TCZ (8 mg/kg) with their current therapy for a year. We evaluated the annualized relapse rate, the Expanded Disability Status Scale score, and numerical rating scales for neurogenic pain and fatigue. Serum levels of anti-AQP4-Ab were measured with AQP4-transfected cells. RESULTS: Six females and one male with NMO were enrolled. After a year of TCZ treatment, the annualized relapse rate decreased from 2.9 ± 1.1 to 0.4 ± 0.8 (p < 0.005). The Expanded Disability Status Scale score, neuropathic pain, and general fatigue also declined significantly. The ameliorating effects on intractable pain exceeded expectations. CONCLUSION: Interleukin-6 receptor blockade is a promising therapeutic option for NMO. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that in patients with NMO, TCZ reduces relapse rate, neuropathic pain, and fatigue.