Efficacy of the anti-IL-6 receptor antibody tocilizumab in neuromyelitis optica: a pilot study.
Efficacy of the anti-IL-6 receptor antibody tocilizumab in neuromyelitis optica: a pilot study.
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DOI：
10.1212/wnl.0000000000000317
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发表时间：
2014-04-15
期刊：
影响因子：
9.9
通讯作者：
Yamamura T
中科院分区：
文献类型：
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作者：
Araki M;Matsuoka T;Miyamoto K;Kusunoki S;Okamoto T;Murata M;Miyake S;Aranami T;Yamamura T
目的评价人源化抗白细胞介素6受体抗体tocilizumab(TCZ)治疗视神经脊髓炎(NMO)的安全性和有效性。7名抗水通道蛋白-4抗体(AQP4-Ab)阳性的NMO或NMO谱系疾病患者根据他们对当前治疗的有限反应性被纳入研究。他们在目前的治疗方法下，每月注射一次TCZ(8 mg/kg)，为期一年。我们评估了年化复发率、扩展残疾状态量表评分和神经源性疼痛和疲劳的数字评定量表。用AQP4转基因细胞检测血清中抗AQP4-Ab的水平。有NMO的6名女性和1名男性入选。治疗1年后，年复发率由治疗前的2.9±1.1降至0.4±0.8(p<；0.005)。扩展残疾状态量表评分、神经病理性疼痛和全身疲劳也显著下降。对顽固性疼痛的缓解效果超出预期。白介素6受体阻断是治疗NMO的一种很有前途的选择。这项研究提供了IV类证据，表明在患有NMO的患者中，TCZ可以降低复发率、神经病理性疼痛和疲劳。
To evaluate the safety and efficacy of a humanized anti–interleukin-6 receptor antibody, tocilizumab (TCZ), in patients with neuromyelitis optica (NMO). 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. 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. Interleukin-6 receptor blockade is a promising therapeutic option for NMO. This study provides Class IV evidence that in patients with NMO, TCZ reduces relapse rate, neuropathic pain, and fatigue.