Review Article

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

Asif Hussain
Epping Family Medical Specialist Center, Victoria, Australia

✉ Correspondence: Asif Hussain Email: drasifhussain@gmail.com

DOI https://doi.org/10.70302/jpsim.v2i2.2127
Volume: 2, Issue 2 Pages: 107–114 Published: 17 Jun 2021
Received: 02 Feb 2021 Accepted: 19 Apr 2021 Published Online: 17 Jun 2021

Abstract

Objective

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.

Methods

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.

Results

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

Conclusion

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.

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

How to Cite This Article

Hussain A. Tocilizumab can be a First Line Treatment for Moderate to Severe Rheumatoid Arthritis: A Literature Review and Meta-Analysis of the Safety and Efficacy. J Pak Soc Intern Med. 2021;2(2):107–114. doi:10.70302/jpsim.v2i2.2127

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

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CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2021 Journal of Pakistan Society of Internal Medicine.
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