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Efficacy of tocilizumab, a humanized anti-IL-6 receptor antibody, in rheumatoid arthritis

Yoshiyuki Ohsugi

Evaluation of: Smolen JS, Beaulieu A, Rubbert-Roth A et al.; OPTION Investigators: Effect of interleukin-6 receptor inhibition with tocilizumab in patients with rheumatoid arthritis (OPTION study): a double-blind, placebo-controlled, randomized trial. Lancet 371, 987–997 (2008). Evidence accumulated suggests a major role of for IL-6 in the pathogenesis of rheumatoid arthritis (RA). Several clinical trials have demonstrated that IL-6 signaling blockade with an anti-IL-6 receptor antibody (tocilizumab) is clinically effective in treating patients with RA. In this study, Smolen et al. report the results of a randomized, double-blind, controlled study that assessed the efficacy of tocilizumab in combination with methotrexate. Active RA patients who were refractory to methotrexate treatment were treated with 8 or 4 mg/kg of tocilizumab, or placebo, intravenously every 4 weeks in combination with methotrexate. At 24 weeks, a 20% improvement of signs and symptoms of RA according to the American College of Rheumatology criteria (ACR20 response) was observed in more patients receiving tocilizumab. This study confirmed the results of the previous investigations, concluding that tocilizumab could be an effective therapeutic approach in patients with moderate to severe active RA.