PMID- 28733791
OWN - NLM
STAT- MEDLINE
DCOM- 20181010
LR  - 20181113
IS  - 1434-9949 (Electronic)
IS  - 0770-3198 (Linking)
VI  - 36
IP  - 10
DP  - 2017 Oct
TI  - Current clinical evidence of tocilizumab for the treatment of ANCA-associated 
      vasculitis: a prospective case series for microscopic polyangiitis in a 
      combination with corticosteroids and literature review.
PG  - 2383-2392
LID - 10.1007/s10067-017-3752-0 [doi]
AB  - The purpose of this study is to report the efficacy and safety of a combination 
      of tocilizumab (TCZ) and high-dose corticosteroid (CS) in two patients with 
      microscopic polyangiitis (MPA) and review the published current clinical evidence 
      on TCZ in patients with anti-neutrophil cytoplasmic antibody-associated 
      vasculitis (AAV), except for large vessel vasculitis (LVV) and polymyalgia 
      rheumatica (PMR). Two MPA patients were treated with TCZ at 8 mg/kg every month 
      for 1 year and CS (prednisolone 1 mg/kg/day for 2 weeks, followed by tapering) in 
      a prospective single-arm, single-center, cohort, open-label pilot study (UMIN 
      clinical trials: 000012072). We performed a systematic literature search (PubMed 
      and ICHUSHI [Japan Medical Abstracts Society] until June 30, 2017) to identify 
      published reports on patients with all vasculitis other than LVV/PMR, who were 
      treated with TCZ. We successfully treated the first patient. However, the other 
      patient had serious infection probably associated with the combination of TCZ and 
      high-dose CS. The literature review identified 22 reports with a total of 34 
      patients who received TCZ for AAV, rheumatoid vasculitis, and other types of 
      vasculitis, in addition to our patients. In 15 of 17 patients (88.2%) with 
      primary and secondary AAV, especially MPA, TCZ induced clinical remission, 
      although TCZ use for rheumatoid vasculitis and vasculitis with mucocutaneous 
      lesions is controversial. This study suggested that TCZ therapy is a potential 
      treatment strategy for patients with AAV. However, TCZ combined with high-dose of 
      CS might not be an appropriate treatment. Future studies are needed to confirm 
      our findings.
FAU - Sakai, Ryota
AU  - Sakai R
AUID- ORCID: 0000-0003-0785-495X
AD  - Department of Rheumatology and Clinical Immunology, Saitama Medical Center, 
      Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan. 
      r_sakai@saitama-med.ac.jp.
AD  - Department of Microbiology and Immunology, School of Medicine, Keio University, 
      Tokyo, Japan. r_sakai@saitama-med.ac.jp.
FAU - Kondo, Tsuneo
AU  - Kondo T
AD  - Department of Rheumatology and Clinical Immunology, Saitama Medical Center, 
      Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
FAU - Kurasawa, Takahiko
AU  - Kurasawa T
AD  - Department of Rheumatology and Clinical Immunology, Saitama Medical Center, 
      Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
FAU - Nishi, Eiko
AU  - Nishi E
AD  - Department of Internal Medicine, Yunomoto Memorial Hospital, Kagoshima, Japan.
FAU - Okuyama, Ayumi
AU  - Okuyama A
AD  - Department of Rheumatology and Clinical Immunology, Saitama Medical Center, 
      Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
FAU - Chino, Kentaro
AU  - Chino K
AD  - Department of Rheumatology and Clinical Immunology, Saitama Medical Center, 
      Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
FAU - Shibata, Akiko
AU  - Shibata A
AD  - Department of Rheumatology and Clinical Immunology, Saitama Medical Center, 
      Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
FAU - Okada, Yusuke
AU  - Okada Y
AD  - Department of Rheumatology and Clinical Immunology, Saitama Medical Center, 
      Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
FAU - Takei, Hirofumi
AU  - Takei H
AD  - Department of Rheumatology and Clinical Immunology, Saitama Medical Center, 
      Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
FAU - Nagasawa, Hayato
AU  - Nagasawa H
AD  - Department of Rheumatology and Clinical Immunology, Saitama Medical Center, 
      Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
AD  - Nagasawa Clinic, Saitama, Japan.
FAU - Amano, Koichi
AU  - Amano K
AD  - Department of Rheumatology and Clinical Immunology, Saitama Medical Center, 
      Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20170721
PL  - Germany
TA  - Clin Rheumatol
JT  - Clinical rheumatology
JID - 8211469
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (IL6 protein, human)
RN  - 0 (Interleukin-6)
RN  - I031V2H011 (tocilizumab)
SB  - IM
MH  - Adrenal Cortex Hormones/*therapeutic use
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*drug therapy
MH  - Antibodies, Monoclonal, Humanized/*therapeutic use
MH  - Clinical Trials as Topic
MH  - Cohort Studies
MH  - Female
MH  - Giant Cell Arteritis/drug therapy
MH  - Humans
MH  - Interleukin-6/metabolism
MH  - Japan
MH  - Male
MH  - Microscopic Polyangiitis/*drug therapy
MH  - Middle Aged
MH  - Pilot Projects
MH  - Polymyalgia Rheumatica/drug therapy
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Vasculitis/blood
OTO - NOTNLM
OT  - ANCA-associated vasculitis
OT  - Interleukin (IL)-6
OT  - Microscopic polyangiitis
OT  - Rheumatoid vasculitis
OT  - Tocilizumab
EDAT- 2017/07/25 06:00
MHDA- 2018/10/12 06:00
CRDT- 2017/07/23 06:00
PHST- 2017/06/27 00:00 [received]
PHST- 2017/07/05 00:00 [accepted]
PHST- 2017/07/04 00:00 [revised]
PHST- 2017/07/25 06:00 [pubmed]
PHST- 2018/10/12 06:00 [medline]
PHST- 2017/07/23 06:00 [entrez]
AID - 10.1007/s10067-017-3752-0 [pii]
AID - 10.1007/s10067-017-3752-0 [doi]
PST - ppublish
SO  - Clin Rheumatol. 2017 Oct;36(10):2383-2392. doi: 10.1007/s10067-017-3752-0. Epub 
      2017 Jul 21.