Blog – Notes Next Door

Tocilizumab

It is an immunosuppresive drug which is originally used for the treatment of rheumatoid arthritis.
It belongs to the class of monoclonal antibodies against interleukin – 6 receptor.
. Interleukin 6 (IL-6) is a cytokine that plays an important role in immune response and is implicated in the pathogenesis of many diseases and is seen to be raised in Covid-19 patients.

The drug is administered through intravenous route.

 

Action in Covid-19:

The pathogenesis of the acute pulmonary treatment injury related to COVID-19 is related to a severe hyperinflammatory state with high amounts of pro-inflammatory cytokines such as IL-6, IL-1, IL-2, and TNF-α. Tocilizumab  is effective in improving outcomes for patients severely affected by the SARS-CoV-2 virus.

Dose details–  It is recommended to  use tocilizumab (single intravenous [IV] dose of tocilizumab 8 mg/kg actual body weight up to 800 mg) in combination with dexamethasone (6 mg daily for up to 10 days) in certain hospitalized patients who are exhibiting rapid respiratory decompensation due to COVID-19. 

Tocilizumab should be avoided in patients who are significantly immunosuppressed, particularly in those with recent use of other biologic immunomodulating drugs, and in patients who have alanine aminotransferase >5 times the upper limit of normal; high risk for gastrointestinal perforation; an uncontrolled serious bacterial, fungal, or non-SARS-CoV-2 viral infection; absolute neutrophil count <500 cells/µL; platelet count <50,000 cells/µL; or known hypersensitivity to tocilizumab.

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