title: Is tocilizumab in combination with traditional DMARDs safe and effective for patients with active RA?
abstract: The interleukin 6 receptor antagonist tocilizumab was investigated in a 24-week, phase III randomized controlled trial for the treatment of active, DMARD-resistant rheumatoid arthritis (TOWARD study). The results indicated that the combination of tocilizumab with standard DMARDs produced a significantly higher clinical response rate than DMARDs alone, according to American College of Rheumatology and European League Against Rheumatism response criteria. Evaluation of adverse events revealed that tocilizumab had a good safety profile, although a slightly increased rate of infections, neutropenia, elevated liver enzyme levels and increased lipid levels were observed in some individuals. Further investigations will be required, however, to clarify which DMARD-tocilizumab combinations provide the best efficacy and safety profile in daily clinical practice and to exclude potential risks associated with long-term interleukin 6 blockade. In conclusion, the introduction of tocilizumab was shown to represent a safe and effective therapeutic approach for the treatment of rheumatoid arthritis refractory to treatment with DMARDs alone, which could substantially improve our treatment options for this condition.
authors.affiliation: Department of Rheumatology and Clinical Immunology at Charité-Universitätsmedizin Berlin, Germany.
authors.forename: Eugen
authors.initials: E
authors.lastname: Feist
authors.forename: Gerd-R
authors.initials: GR
authors.lastname: Burmester