tocilizumab   Click here for help

GtoPdb Ligand ID: 6881

Synonyms: Actemra® | R-1569 | RG-1569 | RHPM-1 | RoActemra®
Approved drug Immunopharmacology Ligand
tocilizumab is an approved drug (Japan (2005), EMA (2009), FDA (2010))
Compound class: Antibody
Comment: Tocilizumab is an anti-IL-6 receptor mAb, with immunosuppressive action [11] that is approved for chronic autoimmune indications.
Annotated peptide sequences for this antibody are available from its IMGT/mAb-DB record.

SARS-CoV-2 and COVID-19: In early March 2020, China's National Health Commission issued guidance that allows use of tocilizumab to treat patients with serious COVID-19-induced lung damage. Tocilizumab is predicted to mitigate against the uncontrolled immune response that is triggered by SARS-CoV-2 infection [3,15] in some patients and which leads to potentially life-threatening damage to the lungs and other organs. Clinical trials are beginning to reveal outcomes (Oct 2020), but the level of benefit remains unclear [4-5,12-13] and requires further investigations. Differences between the studies (timing of treatment, severity of disease at initiation of treatment etc.) make it difficult to compare results and form a solid conclusion. In early January 2021, data was reported from a small cohort of severely ill, mechanically ventilated COVID-19 patients in the REMAP-CAP trial (NCT02735707) who received tocilizumab. The information released (data not yet peer-reviewed) suggested that tocilizumab (compared to standard care) significantly reduced mortality and that patients treated with this mAb were able to leave intensive care 7-10 days earlier than those who didn't receive the drug. This effect appears to be in addition to the clinical benefit conferred by dexamathasone. As a result of this latest report, the UK Department of Health and Social Care was set to issue updated guidance (on 8th Jan; link to gov.uk press release) which will encourage NHS trusts across the UK to immediately begin using existing stocks of tocilizumab in their treatment of critically ill COVID-19 patients in ICUs.

Biosimilars:
NameTrade nameCompanyClinical PhaseIndications
tocilizumab-bavi; BIIB800Tofidence BiogenApproved (2023)As per reference agent
QX003Sn/aQyuns Therapeutics1rheumatoid arthritis
tocilizumab-aazg; MSB11456n/aFresenius Kabi3rheumatoid arthritis
LZM008n/a Livzon Mabpharm1rheumatoid arthritis
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Immunopharmacology Comments
Tocilizumab blocks IL-6R activation, which in turn leads to a reduction in cytokine and acute phase reactant production, and eventual symptomatic relief.
Immunopharmacology Disease
Disease X-Refs Comment References
Temporal arteritis Disease Ontology: DOID:13375
OMIM: 187360
Orphanet: ORPHA397
Approved drug for temporal (giant cell) arteritis (May 2017). 14
Juvenile idiopathic arthritis- systemic OMIM: 604302
An anti-IL-6 therapy approved for sJIA.
Rheumatoid arthritis Disease Ontology: DOID:7148
OMIM: 180300
Tocilizumab was the first humanized mAb to be developed against human IL-6 receptors, and is now an approved therapeutic for RA.
Immunopaedia Case Studies Links
A case of lymphadenopathy and night sweats