Efficacy of the anti–IL-6 receptor antibody tocilizumab in neuromyelitis optica: A pilot study
OBJECTIVE:To evaluate the safety and efficacy of a humanized anti–interleukin-6 receptor antibody, tocilizumab (TCZ), in patients with neuromyelitis optica (NMO). METHODS:Seven patients with anti–aquaporin-4 antibody (AQP4-Ab)-positive NMO or NMO spectrum disorders were recruited on the basis of the...
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| Veröffentlicht in: | Neurology 2014-04, Vol.82 (15), p.1302-1306 |
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| container_title | Neurology |
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| creator | Araki, Manabu Matsuoka, Takako Miyamoto, Katsuichi Kusunoki, Susumu Okamoto, Tomoko Murata, Miho Miyake, Sachiko Aranami, Toshimasa Yamamura, Takashi |
| description | OBJECTIVE:To evaluate the safety and efficacy of a humanized anti–interleukin-6 receptor antibody, tocilizumab (TCZ), in patients with neuromyelitis optica (NMO).
METHODS:Seven patients with anti–aquaporin-4 antibody (AQP4-Ab)-positive NMO or NMO spectrum disorders were recruited on the basis of their limited responsiveness to their current treatment. They were given a monthly injection of TCZ (8 mg/kg) with their current therapy for a year. We evaluated the annualized relapse rate, the Expanded Disability Status Scale score, and numerical rating scales for neurogenic pain and fatigue. Serum levels of anti-AQP4-Ab were measured with AQP4-transfected cells.
RESULTS:Six females and one male with NMO were enrolled. After a year of TCZ treatment, the annualized relapse rate decreased from 2.9 ± 1.1 to 0.4 ± 0.8 (p < 0.005). The Expanded Disability Status Scale score, neuropathic pain, and general fatigue also declined significantly. The ameliorating effects on intractable pain exceeded expectations.
CONCLUSION:Interleukin-6 receptor blockade is a promising therapeutic option for NMO.
CLASSIFICATION OF EVIDENCE:This study provides Class IV evidence that in patients with NMO, TCZ reduces relapse rate, neuropathic pain, and fatigue. |
| doi_str_mv | 10.1212/WNL.0000000000000317 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4001188</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1635018295</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3537-99249e9291a71fc4cb275f5a5517a24dd84ef669e8761ba821fc52a78bd716df3</originalsourceid><addsrcrecordid>eNp9kcFu1DAQhi0EokvhDRDyBYlLiu3YscMBqapKW2kFFxDcjOPYrMGJU9uhSk99h75hnwTDLqVwYC4jzXzzz2h-AJ5idIAJJi8_vl0foLtRY34PrDAjTdXU5NN9sEKIiKoWXOyBRyl9Rag0efsQ7BHa1JSyegU-H1vrtNILDBbmjYFqzO7m6vpsXTUwGm2mHOKvYhf6BeagnXeX86A66EY4mjmGYTHeZZdgmHKRegUP4eR8yDDluV8egwdW-WSe7PI--PDm-P3RabV-d3J2dLiudM1qXrUtoa1pSYsVx1ZT3RHOLFOMYa4I7XtBjW2a1gje4E4JUiBGFBddz3HT23ofvN7qTnM3mF6bMUfl5RTdoOIig3Ly787oNvJL-C5peQsWogi82AnEcD6blOXgkjbeq9GEOUnc1AxhQVpWULpFdQwpRWNv12Akf5ojiznyX3PK2LO7J94O_XajAM93gEpaeRvVqF36wwlKBEZt4cSWuwg-m5i--fnCRLkxyufN_2_4AaQCqoE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1635018295</pqid></control><display><type>article</type><title>Efficacy of the anti–IL-6 receptor antibody tocilizumab in neuromyelitis optica: A pilot study</title><source>MEDLINE</source><source>Journals@Ovid Ovid Autoload</source><source>Alma/SFX Local Collection</source><creator>Araki, Manabu ; Matsuoka, Takako ; Miyamoto, Katsuichi ; Kusunoki, Susumu ; Okamoto, Tomoko ; Murata, Miho ; Miyake, Sachiko ; Aranami, Toshimasa ; Yamamura, Takashi</creator><creatorcontrib>Araki, Manabu ; Matsuoka, Takako ; Miyamoto, Katsuichi ; Kusunoki, Susumu ; Okamoto, Tomoko ; Murata, Miho ; Miyake, Sachiko ; Aranami, Toshimasa ; Yamamura, Takashi</creatorcontrib><description>OBJECTIVE:To evaluate the safety and efficacy of a humanized anti–interleukin-6 receptor antibody, tocilizumab (TCZ), in patients with neuromyelitis optica (NMO).
METHODS:Seven patients with anti–aquaporin-4 antibody (AQP4-Ab)-positive NMO or NMO spectrum disorders were recruited on the basis of their limited responsiveness to their current treatment. They were given a monthly injection of TCZ (8 mg/kg) with their current therapy for a year. We evaluated the annualized relapse rate, the Expanded Disability Status Scale score, and numerical rating scales for neurogenic pain and fatigue. Serum levels of anti-AQP4-Ab were measured with AQP4-transfected cells.
RESULTS:Six females and one male with NMO were enrolled. After a year of TCZ treatment, the annualized relapse rate decreased from 2.9 ± 1.1 to 0.4 ± 0.8 (p < 0.005). The Expanded Disability Status Scale score, neuropathic pain, and general fatigue also declined significantly. The ameliorating effects on intractable pain exceeded expectations.
CONCLUSION:Interleukin-6 receptor blockade is a promising therapeutic option for NMO.
CLASSIFICATION OF EVIDENCE:This study provides Class IV evidence that in patients with NMO, TCZ reduces relapse rate, neuropathic pain, and fatigue.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/WNL.0000000000000317</identifier><identifier>PMID: 24634453</identifier><identifier>CODEN: NEURAI</identifier><language>eng</language><publisher>Hagerstown, MD: American Academy of Neurology</publisher><subject>Adult ; Antibodies, Monoclonal, Humanized - adverse effects ; Antibodies, Monoclonal, Humanized - therapeutic use ; Biological and medical sciences ; Cerebrospinal fluid. Meninges. Spinal cord ; Diseases of visual field, optic nerve, optic chiasma and optic tracts ; Fatigue - drug therapy ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis ; Nervous system (semeiology, syndromes) ; Neuralgia - drug therapy ; Neurology ; Neuromyelitis Optica - drug therapy ; Ophthalmology ; Pilot Projects ; Receptors, Interleukin-6 - antagonists & inhibitors ; Secondary Prevention ; Treatment Outcome</subject><ispartof>Neurology, 2014-04, Vol.82 (15), p.1302-1306</ispartof><rights>2014 American Academy of Neurology</rights><rights>2015 INIST-CNRS</rights><rights>2014 American Academy of Neurology 2014 American Academy of Neurology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3537-99249e9291a71fc4cb275f5a5517a24dd84ef669e8761ba821fc52a78bd716df3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28428109$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24634453$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Araki, Manabu</creatorcontrib><creatorcontrib>Matsuoka, Takako</creatorcontrib><creatorcontrib>Miyamoto, Katsuichi</creatorcontrib><creatorcontrib>Kusunoki, Susumu</creatorcontrib><creatorcontrib>Okamoto, Tomoko</creatorcontrib><creatorcontrib>Murata, Miho</creatorcontrib><creatorcontrib>Miyake, Sachiko</creatorcontrib><creatorcontrib>Aranami, Toshimasa</creatorcontrib><creatorcontrib>Yamamura, Takashi</creatorcontrib><title>Efficacy of the anti–IL-6 receptor antibody tocilizumab in neuromyelitis optica: A pilot study</title><title>Neurology</title><addtitle>Neurology</addtitle><description>OBJECTIVE:To evaluate the safety and efficacy of a humanized anti–interleukin-6 receptor antibody, tocilizumab (TCZ), in patients with neuromyelitis optica (NMO).
METHODS:Seven patients with anti–aquaporin-4 antibody (AQP4-Ab)-positive NMO or NMO spectrum disorders were recruited on the basis of their limited responsiveness to their current treatment. They were given a monthly injection of TCZ (8 mg/kg) with their current therapy for a year. We evaluated the annualized relapse rate, the Expanded Disability Status Scale score, and numerical rating scales for neurogenic pain and fatigue. Serum levels of anti-AQP4-Ab were measured with AQP4-transfected cells.
RESULTS:Six females and one male with NMO were enrolled. After a year of TCZ treatment, the annualized relapse rate decreased from 2.9 ± 1.1 to 0.4 ± 0.8 (p < 0.005). The Expanded Disability Status Scale score, neuropathic pain, and general fatigue also declined significantly. The ameliorating effects on intractable pain exceeded expectations.
CONCLUSION:Interleukin-6 receptor blockade is a promising therapeutic option for NMO.
CLASSIFICATION OF EVIDENCE:This study provides Class IV evidence that in patients with NMO, TCZ reduces relapse rate, neuropathic pain, and fatigue.</description><subject>Adult</subject><subject>Antibodies, Monoclonal, Humanized - adverse effects</subject><subject>Antibodies, Monoclonal, Humanized - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cerebrospinal fluid. Meninges. Spinal cord</subject><subject>Diseases of visual field, optic nerve, optic chiasma and optic tracts</subject><subject>Fatigue - drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neuralgia - drug therapy</subject><subject>Neurology</subject><subject>Neuromyelitis Optica - drug therapy</subject><subject>Ophthalmology</subject><subject>Pilot Projects</subject><subject>Receptors, Interleukin-6 - antagonists & inhibitors</subject><subject>Secondary Prevention</subject><subject>Treatment Outcome</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAQhi0EokvhDRDyBYlLiu3YscMBqapKW2kFFxDcjOPYrMGJU9uhSk99h75hnwTDLqVwYC4jzXzzz2h-AJ5idIAJJi8_vl0foLtRY34PrDAjTdXU5NN9sEKIiKoWXOyBRyl9Rag0efsQ7BHa1JSyegU-H1vrtNILDBbmjYFqzO7m6vpsXTUwGm2mHOKvYhf6BeagnXeX86A66EY4mjmGYTHeZZdgmHKRegUP4eR8yDDluV8egwdW-WSe7PI--PDm-P3RabV-d3J2dLiudM1qXrUtoa1pSYsVx1ZT3RHOLFOMYa4I7XtBjW2a1gje4E4JUiBGFBddz3HT23ofvN7qTnM3mF6bMUfl5RTdoOIig3Ly787oNvJL-C5peQsWogi82AnEcD6blOXgkjbeq9GEOUnc1AxhQVpWULpFdQwpRWNv12Akf5ojiznyX3PK2LO7J94O_XajAM93gEpaeRvVqF36wwlKBEZt4cSWuwg-m5i--fnCRLkxyufN_2_4AaQCqoE</recordid><startdate>20140415</startdate><enddate>20140415</enddate><creator>Araki, Manabu</creator><creator>Matsuoka, Takako</creator><creator>Miyamoto, Katsuichi</creator><creator>Kusunoki, Susumu</creator><creator>Okamoto, Tomoko</creator><creator>Murata, Miho</creator><creator>Miyake, Sachiko</creator><creator>Aranami, Toshimasa</creator><creator>Yamamura, Takashi</creator><general>American Academy of Neurology</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>5PM</scope></search><sort><creationdate>20140415</creationdate><title>Efficacy of the anti–IL-6 receptor antibody tocilizumab in neuromyelitis optica: A pilot study</title><author>Araki, Manabu ; Matsuoka, Takako ; Miyamoto, Katsuichi ; Kusunoki, Susumu ; Okamoto, Tomoko ; Murata, Miho ; Miyake, Sachiko ; Aranami, Toshimasa ; Yamamura, Takashi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3537-99249e9291a71fc4cb275f5a5517a24dd84ef669e8761ba821fc52a78bd716df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Antibodies, Monoclonal, Humanized - adverse effects</topic><topic>Antibodies, Monoclonal, Humanized - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cerebrospinal fluid. Meninges. Spinal cord</topic><topic>Diseases of visual field, optic nerve, optic chiasma and optic tracts</topic><topic>Fatigue - drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neuralgia - drug therapy</topic><topic>Neurology</topic><topic>Neuromyelitis Optica - drug therapy</topic><topic>Ophthalmology</topic><topic>Pilot Projects</topic><topic>Receptors, Interleukin-6 - antagonists & inhibitors</topic><topic>Secondary Prevention</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Araki, Manabu</creatorcontrib><creatorcontrib>Matsuoka, Takako</creatorcontrib><creatorcontrib>Miyamoto, Katsuichi</creatorcontrib><creatorcontrib>Kusunoki, Susumu</creatorcontrib><creatorcontrib>Okamoto, Tomoko</creatorcontrib><creatorcontrib>Murata, Miho</creatorcontrib><creatorcontrib>Miyake, Sachiko</creatorcontrib><creatorcontrib>Aranami, Toshimasa</creatorcontrib><creatorcontrib>Yamamura, Takashi</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Araki, Manabu</au><au>Matsuoka, Takako</au><au>Miyamoto, Katsuichi</au><au>Kusunoki, Susumu</au><au>Okamoto, Tomoko</au><au>Murata, Miho</au><au>Miyake, Sachiko</au><au>Aranami, Toshimasa</au><au>Yamamura, Takashi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of the anti–IL-6 receptor antibody tocilizumab in neuromyelitis optica: A pilot study</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2014-04-15</date><risdate>2014</risdate><volume>82</volume><issue>15</issue><spage>1302</spage><epage>1306</epage><pages>1302-1306</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><coden>NEURAI</coden><abstract>OBJECTIVE:To evaluate the safety and efficacy of a humanized anti–interleukin-6 receptor antibody, tocilizumab (TCZ), in patients with neuromyelitis optica (NMO).
METHODS:Seven patients with anti–aquaporin-4 antibody (AQP4-Ab)-positive NMO or NMO spectrum disorders were recruited on the basis of their limited responsiveness to their current treatment. They were given a monthly injection of TCZ (8 mg/kg) with their current therapy for a year. We evaluated the annualized relapse rate, the Expanded Disability Status Scale score, and numerical rating scales for neurogenic pain and fatigue. Serum levels of anti-AQP4-Ab were measured with AQP4-transfected cells.
RESULTS:Six females and one male with NMO were enrolled. After a year of TCZ treatment, the annualized relapse rate decreased from 2.9 ± 1.1 to 0.4 ± 0.8 (p < 0.005). The Expanded Disability Status Scale score, neuropathic pain, and general fatigue also declined significantly. The ameliorating effects on intractable pain exceeded expectations.
CONCLUSION:Interleukin-6 receptor blockade is a promising therapeutic option for NMO.
CLASSIFICATION OF EVIDENCE:This study provides Class IV evidence that in patients with NMO, TCZ reduces relapse rate, neuropathic pain, and fatigue.</abstract><cop>Hagerstown, MD</cop><pub>American Academy of Neurology</pub><pmid>24634453</pmid><doi>10.1212/WNL.0000000000000317</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Neurology, 2014-04, Vol.82 (15), p.1302-1306 |
| issn | 0028-3878 1526-632X |
| language | eng |
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| source | MEDLINE; Journals@Ovid Ovid Autoload; Alma/SFX Local Collection |
| subjects | Adult Antibodies, Monoclonal, Humanized - adverse effects Antibodies, Monoclonal, Humanized - therapeutic use Biological and medical sciences Cerebrospinal fluid. Meninges. Spinal cord Diseases of visual field, optic nerve, optic chiasma and optic tracts Fatigue - drug therapy Female Humans Male Medical sciences Middle Aged Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis Nervous system (semeiology, syndromes) Neuralgia - drug therapy Neurology Neuromyelitis Optica - drug therapy Ophthalmology Pilot Projects Receptors, Interleukin-6 - antagonists & inhibitors Secondary Prevention Treatment Outcome |
| title | Efficacy of the anti–IL-6 receptor antibody tocilizumab in neuromyelitis optica: A pilot study |
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