title: Efficacy of epidural administration of anti-interleukin-6 receptor antibody onto spinal nerve for treatment of sciatica.
abstract: BACKGROUND
  Interleukin-6 (IL-6) is thought to play a crucial role in the radicular pain caused by lumbar spinal stenosis. However, efficacy of inhibition of IL-6 for sciatica in patients with lumbar spinal stenosis has not been clarified. The purpose of the current study was to examine the effect of the anti-IL-6 receptor monoclonal antibody, tocilizumab, on radicular pain by its epidural administration onto spinal nerves in patients with lumbar spinal stenosis.
  
  
  METHODS
  Sixty patients with low back and radicular leg pain caused by spinal stenosis were investigated. In 30 patients, we infiltrated 2.0 mL of lidocaine and 80 mg of tocilizumab onto the affected spinal nerve, and 2.0 mL of lidocaine and 3.3 mg of dexamethasone were used in 30 patients. Low back pain, leg pain, and leg numbness were evaluated during 1 month after spinal nerve infiltration.
  
  
  RESULTS
  Infiltration of tocilizumab was more effective than dexamethasone for leg pain (3 days, 1, 2, and 4 weeks), low back pain (3 days, 1, 2 and 4 weeks), and leg numbness (3 days, 1 and 2 weeks). No adverse event was observed in either group.
  
  
  CONCLUSIONS
  Our results indicate that the epidural administration of an anti-IL-6 receptor monoclonal antibody, tocilizumab, onto the spinal nerve produced reduction of radicular leg pain, numbness, and low back pain without adverse event. IL-6 may be one of the inducers of pain caused by spinal stenosis in humans.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Japan. sohtori@faculty.chiba-u.jp
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohtori
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyagi
authors.forename: Yawara
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Gen
authors.initials: G
authors.lastname: Inoue
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Orita
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Ochiai
authors.forename: Shunji
authors.initials: S
authors.lastname: Kishida
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kuniyoshi
authors.forename: Junichi
authors.initials: J
authors.lastname: Nakamura
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Aoki
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Gen
authors.initials: G
authors.lastname: Arai
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kamoda
authors.forename: Miyako
authors.initials: M
authors.lastname: Suzuki
authors.forename: Masashi
authors.initials: M
authors.lastname: Takaso
authors.forename: Takeo
authors.initials: T
authors.lastname: Furuya
authors.forename: Gou
authors.initials: G
authors.lastname: Kubota
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sakuma
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Oikawa
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Toyone
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural / Q000379:methods*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D019947:Receptors, Interleukin-6 / Q000037:antagonists & inhibitors; D012585:Sciatica / Q000188:drug therapy* / Q000209:etiology; D013127:Spinal Nerves / Q000187:drug effects*; D013130:Spinal Stenosis / Q000150:complications*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D019947:Receptors, Interleukin-6; C502936:tocilizumab