PMID- 29362962
OWN - NLM
STAT- MEDLINE
DCOM- 20181017
LR  - 20181017
IS  - 1434-9949 (Electronic)
IS  - 0770-3198 (Linking)
VI  - 37
IP  - 6
DP  - 2018 Jun
TI  - Tocilizumab reduces complement C3 and C4 serum levels in rheumatoid arthritis
      patients.
PG  - 1695-1700
LID - 10.1007/s10067-018-3992-7 [doi]
AB  - Tocilizumab, an anti-interleukin-6 receptor monoclonal antibody, is known to be
      able to rapidly reduce acute phase reactants. Although complement components are 
      part of the acute phase, no data are available on a possible effect of
      tocilizumab on complement proteins. Serum levels of complement components C3 and 
      C4 were retrospectively assessed in 19 consecutive rheumatoid arthritis patients 
      eligible for tocilizumab treatment. Tocilizumab was found to reduce all known
      acute phase reactants, including C3 and C4 levels. C3 and C4 were found to
      decrease as early as 4 weeks after the first tocilizumab infusion. On average, C3
      decreased by 24.02, 27.35, 33.62, and 32.81%, as compared to pre-treatment
      values, after 1, 3, 6, and 12 months of therapy, respectively; likewise, C4
      decreased by 44.74, 43.40, 54.33, and 54.56% at the same time points with respect
      to pre-treatment values. A discrete proportion of patients (38.46 and 30.76% for 
      C3 and C4, respectively) displayed subnormal complement serum levels early (4
      weeks) after initiation of tocilizumab treatment, which raised suspicion for
      complement consumption. However, no circulating immunocomplexes were found nor
      did any patient ever display clinical features of immunocomplex disease during a 
      median follow-up of 38 months. After 12 months of therapy, 68.75 and 56.25% of
      patients had abnormally low C3 and C4 serum levels, respectively. Reduction in C3
      and C4 serum levels should be included among the anti-inflammatory effects
      exerted by tocilizumab and are thus to be considered as an expected outcome of
      the mechanism of action of this drug.
FAU - Romano, Ciro
AU  - Romano C
AUID- ORCID: http://orcid.org/0000-0002-5807-6601
AD  - Division of Internal Medicine, Department of Medical and Surgical Sciences,
      "Luigi Vanvitelli" University of Campania, Piazza Miraglia, 3, 80138, Naples,
      Italy. ciro.romano@unicampania.it.
FAU - Del Mastro, Andrea
AU  - Del Mastro A
AD  - Division of Internal Medicine, Ospedale del Mare, Naples, Italy.
FAU - Sellitto, Ausilia
AU  - Sellitto A
AD  - "S. Carlo" Regional Hospital, Potenza, Italy.
FAU - Solaro, Eleonora
AU  - Solaro E
AD  - Division of Internal Medicine, Department of Medical and Surgical Sciences,
      "Luigi Vanvitelli" University of Campania, Piazza Miraglia, 3, 80138, Naples,
      Italy.
FAU - Esposito, Sergio
AU  - Esposito S
AD  - Division of Internal Medicine, Department of Medical and Surgical Sciences,
      "Luigi Vanvitelli" University of Campania, Piazza Miraglia, 3, 80138, Naples,
      Italy.
FAU - Cuomo, Giovanna
AU  - Cuomo G
AD  - Division of Internal Medicine, Department of Medical and Surgical Sciences,
      "Luigi Vanvitelli" University of Campania, Piazza Miraglia, 3, 80138, Naples,
      Italy.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20180123
PL  - Germany
TA  - Clin Rheumatol
JT  - Clinical rheumatology
JID - 8211469
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Complement C3)
RN  - 0 (Complement C4)
RN  - I031V2H011 (tocilizumab)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antibodies, Monoclonal, Humanized/pharmacology/*therapeutic use
MH  - Arthritis, Rheumatoid/blood/*drug therapy
MH  - Complement C3/*metabolism
MH  - Complement C4/*metabolism
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Young Adult
OTO - NOTNLM
OT  - C3
OT  - C4
OT  - Complement proteins
OT  - Rheumatoid arthritis
OT  - Tocilizumab
EDAT- 2018/01/25 06:00
MHDA- 2018/10/18 06:00
CRDT- 2018/01/25 06:00
PHST- 2017/11/21 00:00 [received]
PHST- 2018/01/15 00:00 [accepted]
PHST- 2018/01/10 00:00 [revised]
PHST- 2018/01/25 06:00 [pubmed]
PHST- 2018/10/18 06:00 [medline]
PHST- 2018/01/25 06:00 [entrez]
AID - 10.1007/s10067-018-3992-7 [doi]
AID - 10.1007/s10067-018-3992-7 [pii]
PST - ppublish
SO  - Clin Rheumatol. 2018 Jun;37(6):1695-1700. doi: 10.1007/s10067-018-3992-7. Epub
      2018 Jan 23.