Tocilizumab can be a First Line Treatment for Moderate to Severe Rheumatoid Arthritis: A Literature Review and Meta-Analysis of the Safety and Efficacy


  • Author- Asif Hussain


Tocilizumab (TCZ) is a humanized monoclonal antibody that targets receptor alpha for Interleukin (IL)-6. It helps control disease activity, complications, and systemic constitutional symptoms of moderate to severe RAin patients not responding to other biological drugs, including TNF inhibitors. This literature review and meta-analysis aims to search for literature published within the last twelve years to assess infection risk, safety, and efficacy of TCZ use for rheumatoid arthritis.


The review focused on high-quality studies published in the last fifteen years and excludes older studies, lowlevel research & studies not published in English. Of the 101 reviews found, forty-nine (49) are selected using CASPtools including nine (09) RCTs having 6711 patients for meta-analysis. Med- calc was used for statistical analysis, including odd ratio, 95% confidence interval, p-values, and heterogeneity.


 TCZ has superior efficacy compared with placebo and other bDMARD with MTX (OR: 4.518, 95% CI: 2.092 to 9.758). However, TCZ has a higher prevalence of total AE (OR 1.67, CI: 1.354 to 2.062, p vale


 Apart from the slightly higher risk of acute bacterial infections and total AEs, TCZ has superior efficacy and similar safety profile for SAE when compared with other DMARDs. TCZ can be a first-line treatment for moderate to severe RApatients.


Tocilizumab (TCZ) related infections, TCZ safety & efficacy, TCZ adverse events, TCZ monotherapy, TCZ vs. other biological drugs for Rheumatoid arthritis.