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Neurology. 2014 Apr 15;82(15):1302-6. doi: 10.1212/WNL.0000000000000317. Epub 2014 Mar 14.

Efficacy of the anti-IL-6 receptor antibody tocilizumab in neuromyelitis optica: a pilot study.

Author information

1
From the Multiple Sclerosis Center (M.A., T.O., S.M., T.A., T.Y.) and Department of Neurology (T.O., M.M.), National Center Hospital, and Department of Immunology, National Institute of Neuroscience (T.M., S.M., T.A., T.Y.), National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (K.M., S.K.), Kinki University School of Medicine, Osaka; and Department of Pediatrics (T.M.), Graduate School of Medicine, University of Tokyo, Japan.

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.

PMID:
24634453
PMCID:
PMC4001188
DOI:
10.1212/WNL.0000000000000317
[Indexed for MEDLINE]
Free PMC Article

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