Efficacy of the anti–IL-6 receptor antibody tocilizumab in neuromyelitis optica
Open Access
- 15 April 2014
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 82 (15), 1302-1306
- https://doi.org/10.1212/wnl.0000000000000317
Abstract
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.Keywords
This publication has 12 references indexed in Scilit:
- Association of Neuromyelitis Optica With Severe and Intractable PainArchives of Neurology, 2012
- Clinical improvement in a patient with neuromyelitis optica following therapy with the anti-IL-6 receptor monoclonal antibody tocilizumabModern Rheumatology, 2012
- Therapeutic Targeting of the Interleukin-6 ReceptorAnnual Review of Pharmacology and Toxicology, 2012
- Pain in neuromyelitis optica and its effect on quality of lifeNeurology, 2011
- Interleukin 6 signaling promotes anti-aquaporin 4 autoantibody production from plasmablasts in neuromyelitis opticaProceedings of the National Academy of Sciences of the United States of America, 2011
- AQP4 antibodies in neuromyelitis optica: diagnostic and pathogenetic relevanceNature Reviews Neurology, 2010
- The Role of Glia and the Immune System in the Development and Maintenance of Neuropathic PainPain Practice, 2010
- A Key Role for gp130 Expressed on Peripheral Sensory Nerves in Pathological PainJournal of Neuroscience, 2009
- What are the therapeutic advances in neurology? Opinions from world expertsTherapeutic Advances in Neurological Disorders, 2008
- Review: Treatment of neuromyelitis optica: Current debateTherapeutic Advances in Neurological Disorders, 2008