PMID- 25045250
OWN - NLM
STAT- MEDLINE
DCOM- 20160418
LR  - 20220331
IS  - 1177-8881 (Electronic)
IS  - 1177-8881 (Linking)
VI  - 8
DP  - 2014
TI  - Drug delivery options to increase patient adherence and satisfaction in the 
      management of rheumatoid arthritis -- focus on subcutaneous tocilizumab.
PG  - 913-9
LID - 10.2147/DDDT.S52099 [doi]
AB  - Rheumatoid arthritis (RA) is a chronic, progressive, inflammatory disease 
      associated with joint destruction. Tocilizumab (TCZ) is a humanized monoclonal 
      anti-interleukin-6 receptor antibody that was initially developed for use as an 
      intravenous (IV) infusion. Previous studies have shown that TCZ-IV is an 
      important treatment option in patients with moderate-to-severe RA. A subcutaneous 
      (SC) formulation of 162 mg TCZ that was recently developed and approved provides 
      an additional treatment option for RA patients. In the present review, we provide 
      an update on the efficacy and safety of TCZ-SC, compared with TCZ-IV. The TCZ-SC 
      doses of 162 mg every 2 weeks (q2w) or weekly (qw) were selected based on 
      pharmacokinetic and pharmacodynamic studies. Both TCZ-SC q2w and qw regimens 
      showed equivalent effects to TCZ-IV in most patients; however, the TCZ-SC qw 
      regimen consistently showed a more rapid effect in terms of C-reactive protein 
      normalization. Randomized controlled studies showed that TCZ-SC monotherapy or 
      combined with disease-modifying antirheumatic drugs demonstrated comparable 
      efficacy to TCZ-IV in patients who were both biologic-naive and refractory to 
      tumor necrosis factor inhibitors. TCZ-SC at both qw and q2w were generally 
      well-tolerated for up to 24 weeks. There was a low rate of withdrawal due to 
      adverse events, and their incidence was comparable with that seen with TCZ-IV. An 
      injection site reaction was seen in approximately 10% of patients who received 
      the subcutaneous formulation. In conclusion, although clinical results are still 
      limited, the currently available evidence suggests that TCZ-SC is a promising 
      treatment for moderate-to-severe RA, both as monotherapy and combination therapy. 
      More data is needed to determine the optimal dosing schedule.
FAU - Nakashima, Yasuharu
AU  - Nakashima Y
AD  - Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.
FAU - Kondo, Masakazu
AU  - Kondo M
AD  - Kondo Clinic of Rheumatology and Orthopaedic Surgery, Fukuoka, Japan.
FAU - Miyahara, Hisaaki
AU  - Miyahara H
AD  - Department of Orthopaedic Surgery and Rheumatology, Clinical Research Institute, 
      National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
FAU - Iwamoto, Yukihide
AU  - Iwamoto Y
AD  - Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20140704
PL  - New Zealand
TA  - Drug Des Devel Ther
JT  - Drug design, development and therapy
JID - 101475745
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - I031V2H011 (tocilizumab)
SB  - IM
MH  - Antibodies, Monoclonal, Humanized/*administration & 
      dosage/pharmacokinetics/therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - *Drug Delivery Systems
MH  - Humans
MH  - Injections, Subcutaneous
MH  - *Medication Adherence
MH  - *Patient Satisfaction
PMC - PMC4094568
OTO - NOTNLM
OT  - review
OT  - rheumatoid arthritis
OT  - subcutaneous injection
OT  - tocilizumab
EDAT- 2014/07/22 06:00
MHDA- 2016/04/19 06:00
PMCR- 2014/07/04
CRDT- 2014/07/22 06:00
PHST- 2014/07/22 06:00 [entrez]
PHST- 2014/07/22 06:00 [pubmed]
PHST- 2016/04/19 06:00 [medline]
PHST- 2014/07/04 00:00 [pmc-release]
AID - dddt-8-913 [pii]
AID - 10.2147/DDDT.S52099 [doi]
PST - epublish
SO  - Drug Des Devel Ther. 2014 Jul 4;8:913-9. doi: 10.2147/DDDT.S52099. eCollection 
      2014.