tocilizumabi

Tocilizumab is a humanized monoclonal antibody that targets the interleukin-6 receptor (IL-6R), blocking IL-6–mediated signaling. By inhibiting both soluble and membrane-bound IL-6 receptors, it reduces inflammatory processes in several immune-mediated diseases.

Approved indications include rheumatoid arthritis in adults, polyarticular juvenile idiopathic arthritis and systemic juvenile idiopathic arthritis, giant cell arteritis, and cytokine release syndrome associated with CAR-T cell therapy. It is also used for adult-onset Still's disease in some regions. Tocilizumab is marketed under the brand name Actemra and is available in intravenous and subcutaneous formulations.

Administration and dosing depend on the condition and route. Intravenous infusions are typically given every four weeks, with dosing based on weight and clinical response. Subcutaneous injections are commonly administered as 162 mg every one or two weeks, with adjustments based on efficacy and tolerance. Treatment regimens may be tailored to individual patients and local guidelines.

Safety and monitoring considerations are important. Tocilizumab carries a risk of serious infections, including tuberculosis; patients should be screened for latent tuberculosis before starting therapy and monitored for signs of infection during treatment. Other common adverse effects include neutropenia, elevated liver enzymes, dyslipidemia, hypertension, and upper respiratory infections. Gastrointestinal perforation risk exists, particularly in patients with diverticular disease. Liver function tests, lipid panels, and neutrophil counts should be monitored regularly, and vaccinations should be updated prior to initiating therapy, avoiding live vaccines during treatment where possible.

Pregnancy and lactation require careful consideration; use during pregnancy is generally avoided unless potential benefits justify the risks. Tocilizumab is part of a broader strategy for managing inflammatory diseases, often alongside other disease-modifying therapies.