Related Experiment Video
Updated: May 29, 2025

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
Published on: May 16, 2025
Efficacy and Safety of Tocilizumab in Polymyalgia Rheumatica: A Systematic Review and Meta-Analysis
Meha Sharma1, Siddharth Kumar Das2, Ritin Mohindra3
1Department of Rheumatology, Center for Endocrinology Diabetes Arthritis and Rheumatism (CEDAR) Superspeciality Healthcare, New Delhi, India.
Aims:
No meta-analysis has holistically analyzed and summarized the efficacy and safety of tocilizumab in polymyalgia rheumatica (PMR). We undertook this meta-analysis to address this knowledge-gap.
Methods:
Electronic databases were searched for RCTs involving patients living with PMR receiving tocilizumab in intervention arm, and placebo/active comparator in control arm. Primary outcome was to evaluate percentage of patients able to achieve C-reactive protein PMR assessment score (CRP-PMR-AS) < 10 or prednisolone dose < 5 mg/day or > 10 mg/dL decline in prednisolone from baseline. Secondary outcomes were to determine percentage of patients able to totally stop prednisolone and adverse-events.
Results:
From initially screened 115 articles, data from 2 RCTs (136 patients) was analyzed. In addition, a descriptive analysis of 8 observational studies (356 patients) was also done. After 24-weeks of clinical use, patients with PMR receiving tocilizumab had significantly higher chances of achieving composite primary end-point defined as CRP-PMR-AS < 10 and either prednisone dosage < 5 mg/day or decrease in prednisolone dosage by > 10 mg/day compared to baseline [odds ratio (OR) 4.89 (95% CI: 2.34-10.23); p < 0.001; I2 = 0%], compared to placebo. Patients with PMR receiving tocilizumab also had significantly higher chances of being able to stop prednisolone compared to placebo [OR 4.45 (95% CI: 2.06-9.61); p < 0.001; I2 = 0%]. Occurrence of total adverse-events [risk ratio (RR) 1.24 (95% CI: 0.50-3.12); p = 0.64; I2 = 0%], adverse-events leading to treatment discontinuation [RR 0.45 (95% CI: 0.10-2.02); p = 0.29; I2 = 17%], and infections [RR 1.71 (95% CI: 0.83-3.52); p = 0.14; I2 = 6%] were comparable in patients receiving tocilizumab as compared to placebo. Observational studies have noted lung infections, neutropenia and increased cholesterol with tocilizumab use.
Conclusion:
Tocilizumab is well tolerated and is effective for managing PMR. Tocilizumab is an effective glucocorticoid sparing agent in PMR.
Insights
Tocilizumab effectively treats polymyalgia rheumatica (PMR), significantly improving patient outcomes and allowing for reduced corticosteroid use. The drug is well-tolerated, with comparable adverse events to placebo in clinical trials.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Polymyalgia rheumatica (PMR) is a chronic inflammatory condition.
- Current treatments often involve long-term corticosteroid use, associated with significant side effects.
- A need exists for effective, steroid-sparing therapies in PMR management.
Conclusions:
- Tocilizumab is an effective and well-tolerated treatment for polymyalgia rheumatica.
- Tocilizumab demonstrates significant glucocorticoid-sparing properties in PMR management.
- Further research may explore specific adverse event profiles in long-term use.
More Related Videos
06:37Using Reference Reagents to Confirm Robustness of Cytokine Release Assays for the Prediction of Monoclonal Antibody Safety
Published on: September 15, 2023
09:34Dynamic Imaging of Chimeric Antigen Receptor T Cells with [18F]Tetrafluoroborate Positron Emission Tomography/Computed Tomography
Published on: February 17, 2022
Related Concept Videos
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
T Cell Types and Functions
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
The JAK-STAT Signaling Pathway
Myasthenia Gravis: Overview and Treatment
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...