Tocilizumab

 

What is Tocilizumab?

Tocilizumab is a targeted disease modifying anti-rheumatic drug (DMARD) that is used to reduce inflammation produced by the body. In certain diseases the immune system is over active, this can target healthy tissues such as joints and blood vessels. Tocilizumab works on the inflammatory pathway to block a protein called IL-6, thereby reducing the symptoms you get from arthritis such as pain and joint swelling, vasculitis such as headaches and reduces the chance of further damage to the joints or organs.

 

What is Tocilizumab used for?

Tocilizumab is used for the treatments of inflammatory diseases such as rheumatoid arthritis and giant cell arteritis (GCA).

 

How is it taken?

Tocilizumab can be taken in 2 ways and can be given alongside other DMARDs such as methotrexate, or taken on its own.

 

Subcutaneous injection

Tocilizumab can be taken as an injection into the layer of fat between the skin and muscle. This is called a subcutaneous injection and is usually given into the thigh or abdomen. It is given at a dose of 162mg once a week.

The injection device is available as a pen or prefilled syringe. It should be stored in the fridge at home.

You will require your bloods to be monitored whilst on the subcutaneous injections; these are done every 8 weeks for the first 4 months and then every 3 months thereafter. If you are on other DMARDs that require blood monitoring, this should be continued as well.

 

Infusion

It can also be given as an injection into the vein through a drip. This is called an intravenous infusion and is usually given in the rheumatology day unit. You will be monitored throughout and for 1-2 hours after this to make sure you have not developed and side effects. The dose is calculated from your weight and it is given every 4 weeks.

Whilst you are receiving the infusions you will need your bloods monitored, this is initially done every month for 6 months, after this it can be stepped down to every 3 months.

 

The medication can take up to 12 weeks to have an effect. You will be reviewed in clinic at around 3-4 months to see how you are getting along.

If you symptoms are well controlled, your doses can be gradually reduced. Increasing the time between injections does this.

 

Side effects 

There are a few possible side effects that can occur in a small number of people that take tocilizumab, these include:

 

 

Cautions of use 

Interactions with other medications

Contraindications of other conditions

Operations

During pregnancy and breastfeeding

Alcohol

Vaccinations

 

Useful Links

Versus Arthritis: http://www.versusarthritis.org