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- Title
Tocilizumab for the Treatment of Familial Mediterranean Fever—A Randomized, Double-Blind, Placebo-Controlled Phase II Study.
- Authors
Henes, Joerg C.; Saur, Sebastian; Kofler, David M.; Kedor, Claudia; Meisner, Christoph; Schuett, Marion; Krusche, Martin; Koetter, Ina; Xenitidis, Theodoros; Schulze-Koops, Hendrik; Feist, Eugen
- Abstract
Background: The purpose of this trial was to evaluate the effectiveness and safety of the IL-6 receptor antibody Tocilizumab (TCZ) in the treatment of Familial Mediterranean Fever (FMF). Methods: This was a randomized, double-blinded, placebo-controlled phase II trial in adult patients with active FMF and an inadequate response or intolerance to colchicine (crFMF). The physician's global assessment of disease activity (PGA), based on a five-point scale for six symptoms, was used as a clinical score, which had to be >2 at screening, together with elevated c-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) and serum amyloid A (SAA) levels, to be eligible for inclusion. Patients were randomized 1:1 to either receive monthly TCZ or a placebo over a period of 24 weeks. The primary endpoint was the number of patients achieving an adequate response to treatment at week 16, defined as a PGA of ≤2 and normalized ESR or CRP and normalized SAA. Results: We randomized 25 patients with a median age of 31 years. At week 16, an adequate treatment response was achieved by two patients in the TCZ and none of the patients in the placebo arm (p = 0.089). SAA levels normalized with TCZ, but not with the placebo (p = 0.015). Conclusion: In this first randomized, placebo-controlled study in patients with active crFMF, more patients in the TCZ arm experienced a response to treatment in comparison to those receiving the placebo. As the prevention of amyloidosis is a major treatment goal in FMF, the normalization of SAA in TCZ-treated patients is essential. These findings have to be confirmed in a larger trial.
- Subjects
FAMILIAL Mediterranean fever; BLOOD sedimentation; TOCILIZUMAB; RECEPTOR antibodies; C-reactive protein
- Publication
Journal of Clinical Medicine, 2022, Vol 11, Issue 18, pN.PAG
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm11185360