Tocilizumab is an interleukin-6 receptor antagonist used in the treatment of rheumatoid arthritis (RA). It is known to induce remission and inhibit radiographic progression in RA. Tocilizumab may be administered either intravenously or subcutaneously. Its effect on lipid levels and the cardiovascular risk has not been fully investigated. The aim was to study the effect of tocilizumab administered either iv or sc on disease activity, lipid levels and cardiovascular risk in RA patients.
Tocilizumab was administered iv 8 mg/kg/ 4wks (maximum dose 800 mg) in 35 patients with RA for a period of 52 weeks. Tocilizumab was administered sc 162 mg/wk in 70 patients with RA for 52 weeks. Inflammation indices, ESR and CRP and lipid levels were measured before and 52 weeks after tocilizumab administration. The DAS 28 disease activity index was also calculated.
Inflammation indices ESR and CRP decreased significantly (P < 0.001) after tocilizumab administration in both the iv and sc groups. The DAS 28 disease activity index decreased after tocilizumab (P < 0.001) in both groups. Total cholesterol and HDL cholesterol increased (P < 0.001) after tocilizumab administration, LDL cholesterol and triglyceride levels also increased in both the iv and sc groups (P < 0.001). No acute cardiovascular events were recorded during the study or thereafter in the long–term follow–up of the patients.
Tocilizumab administered either iv or sc in patients with RA was shown to decrease inflammation indices and disease activity. Lipid levels increased significantly. However, total cholesterol increased in parallel with HDL cholesterol. Cardiovascular events were not observed during the study period or in the long– term follow–up of the patients. It appears that tocilizumab may be accompanied by lipid level alterations, cardiovascular risk not increasing as the adverse effects of total cholesterol may be counteracted by HDL cholesterol.
05 Sep 2020 - 09 Sep 2020