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Severe Infections in Patients Treated with Tocilizumab for Systemic Diseases Other Than Rheumatoid Arthritis: A

Florent Broca1, Odile Souchaud-Debouverie1, Evelyne Liuu2

  • 1Department of Internal Medicine, Poitiers University Hospital, Poitiers, France.

European Journal of Rheumatology
|September 22, 2022
PubMed
Abstract

Insights

Severe infections in patients treated with tocilizumab for systemic diseases (excluding rheumatoid arthritis) occurred at a rate of 3.2 per 100 patient-years. Bacterial infections were most common, and C-reactive protein levels may aid diagnosis.

Area of Science:

  • Immunology
  • Rheumatology
  • Infectious Diseases

Background:

  • Tocilizumab is an interleukin-6 receptor inhibitor used for various systemic inflammatory diseases.
  • Understanding infection risk in patients treated with tocilizumab for non-rheumatoid arthritis indications is crucial.

Purpose of the Study:

  • To describe the incidence and characteristics of severe infections in patients receiving tocilizumab for systemic diseases other than rheumatoid arthritis.
  • To evaluate the association between inflammatory markers and severe infections.

Main Methods:

  • Retrospective data collection from medical records of patients treated with tocilizumab for systemic diseases (excluding RA, PsA, and sJIA) between January 2012 and July 2020.
  • Analysis of infectious events, focusing on severe infections, their sites, and causative agents.

Main Results:

  • 37 patients were included, predominantly with giant cell arteritis.
  • An incidence rate of 3.2 severe infections per 100 patient-years was observed, primarily bacterial infections affecting the lower respiratory tract and skin.
  • Severe bacterial infections were linked to a pronounced inflammatory response, despite tocilizumab treatment. No cases of tuberculosis or viral hepatitis reactivation were reported.

Conclusions:

  • The incidence of severe infections appears lower than in rheumatoid arthritis patients treated with tocilizumab.
  • C-reactive protein (CRP) levels may assist in diagnosing bacterial infections in patients on tocilizumab.
  • Further research with larger cohorts is necessary to identify specific risk factors for severe infections.

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