Study on the safety and efficacy of tocilizumab, an anti-IL-6 receptor antibody, in patients with rheumatoid arthritis complicated with AA amyloidosis

Ippei Miyagawa, Shingo Nakayamada, Kazuyoshi Saito, Kentaro Hanami, Masao Nawata, Norifumi Sawamukai, Kazuhisa Nakano, Kunihiro Yamaoka, Yoshiya Tanaka

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objectives: Although treatment of rheumatoid arthritis (RA) has progressed by the use of biologics, amyloid A (AA) amyloidosis is still an intractable complication in patients with RA. In the present study, safety and efficacy of 1-year treatment with an anti-IL-6 receptor antibody tocilizumab (TCZ) on RA and AA amyloidosis were estimated. Methods: TCZ (8 mg/kg every 4 weeks) was administered to five RA patients complicated with AA amyloidosis. The primary end point was improvement in renal dysfunction and the secondary end point was CDAI at 1 year after the treatment. Results: An improvement in the renal dysfunction, including urinary protein secretion, was found, in four patients including two patients who were refractory to etanercept, with a remarkable decrease of SAA concentration, and the progression of organ dysfunction was prevented at 1 year in all patients treated with TCZ. The mean clinical disease activity index decreased from 33.9 to 4.7 (p = 0.012) in five patients treated with TCZ for 1 year. Three non-serious adverse events were observed in two patients. Conclusions: TCZ ameliorates renal dysfunction in RA patients complicated with AA amyloidosis who are refractory to conventional therapies, thereby suggesting that TCZ has a potential to regulate AA amyloidosis.

Original languageEnglish
Pages (from-to)405-409
Number of pages5
JournalModern rheumatology
Volume24
Issue number3
DOIs
Publication statusPublished - 2014 May

Keywords

  • AA Amyloidosis
  • Rheumatoid Arthritis
  • Tocilizumab
  • Treatment

ASJC Scopus subject areas

  • Rheumatology

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    Miyagawa, I., Nakayamada, S., Saito, K., Hanami, K., Nawata, M., Sawamukai, N., Nakano, K., Yamaoka, K., & Tanaka, Y. (2014). Study on the safety and efficacy of tocilizumab, an anti-IL-6 receptor antibody, in patients with rheumatoid arthritis complicated with AA amyloidosis. Modern rheumatology, 24(3), 405-409. https://doi.org/10.3109/14397595.2013.844294