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Vol. 218. Num. 6.August - September 2018
Pages 271-326
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Vol. 218. Num. 6.August - September 2018
Pages 271-326
Review
DOI: 10.1016/j.rceng.2018.02.010
Use of tocilizumab in systemic sclerosis: A brief literature review
Utilización de tocilizumab en la esclerosis sistémica: breve revisión de la literatura
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A. Fernández-Codinaa,b,
Corresponding author
doccodina@gmail.com

Corresponding author.
, J. Fernández-Fernándezc, A. Fernández-Pantigad, on behalf VII Master's final workgroup on the Clinical Management of Systemic Autoimmune Diseases of the Spanish Society of Internal Medicine 1
a Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitari Vall d’Hebron, Barcelona, Spain
b Rheumatology Division, Department of Medicine, University of Western Ontario, London, ON, Canada
c Servicio de Medicina Interna, Hospital de Mataró, Mataró, Spain
d Servicio de Medicina Interna, Hospital Universitario Central de Asturias, Oviedo, Spain
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Table 1. Design and epidemiological and clinical characteristics of the reviewed studies that included patients with systemic scleroderma treated with tocilizumab.
Table 2. Results on skin and lung involvement in studies on patients with systemic sclerosis treated with tocilizumab.
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Abstract

The available treatments for systemic sclerosis (SS) have limited effectiveness. Treatment with tocilizumab (TCZ), a biological drug that inhibits interleukin 6 (IL-6), has recently been proposed. In this study, we conducted a literature review to assess the safety and efficacy of TCZ in SS. We found 52 articles, 10 of which we selected after evaluating the articles. In a randomized clinical trial, TCZ showed a nonsignificant improvement in the degree of skin induration, while another observational study showed neutral results. In this same clinical trial, the functional respiratory parameters showed a certain degree of stabilization. The safety profile of TCZ is acceptable; however, the current evidence regarding treatment of SS with TCZ is highly limited, although the drug could have a beneficial effect in skin disorder. New clinical trials are needed to determine the usefulness of TCZ in SS.

Keywords:
Systemic sclerosis
Tocilizumab
Treatment
Resumen

Los tratamientos disponibles para la esclerosis sistémica (ES) tienen una efectividad limitada. Recientemente se ha propuesto el tratamiento con tocilizumab (TCZ), un fármaco biológico que inhibe la interleucina 6 (IL6). En este trabajo se realiza una revisión de la literatura para evaluar la eficacia y seguridad de TCZ en ES. Se han encontrado 52 artículos, de los que, tras su evaluación, se han seleccionado solo 10. En un ensayo clínico aleatorizado TCZ demostró una mejoría no significativa del grado de induración cutánea, mientras que en un estudio observacional los resultados fueron neutros. En dicho ensayo clínico, los parámetros funcionales respiratorios mostraron cierto grado de estabilización. El perfil de seguridad de TCZ es aceptable. La evidencia actual en cuanto al tratamiento de la ES con TCZ es muy limitada, aunque el fármaco podría tener un efecto beneficioso en la afectación cutánea. Se requieren nuevos ensayos clínicos para comprobar su utilidad en ES.

Palabras clave:
Esclerosis sistémica
Tocilizumab
Tratamiento

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