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Good medium-term efficacy of tocilizumab in DMARD and anti-TNF-α therapy resistant reactive amyloidosis
  1. Markku Hakala1,2,3,
  2. Kai Immonen4,
  3. Markku Korpela5,
  4. Mikko Vasala6,
  5. Markku J Kauppi3
  1. 1Department of Musculoskeletal Medicine and Rehabilitation, Medical School, University of Tampere, Tampere, Finland
  2. 2Rehabilitation Center, Päijät-Häme Central Hospital, Lahti, Finland
  3. 3Division of Rheumatology, Department of Medicine, Päijät-Häme Central Hospital, Lahti, Finland
  4. 4Department of Medicine, North-Karelia Central Hospital, Joensuu, Finland
  5. 5Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
  6. 6Department of Medicine, Kainuu Central Hospital, Kajaani, Finland
  1. Correspondence to Professor Markku Hakala, Division of Rheumatology, Department of Medicine, Päijät-Häme Central Hospital, Keskussairaalankatu 7, Lahti 15850, Finland; markku.hakala{at}fimnet.fi

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Incidence of reactive amyloidosis associated with rheumatic diseases is markedly decreasing1 as the presence of organ failure such as end-stage renal disease.2 However, we still encounter new cases of amyloidosis. While anti-TNF-α therapy may be effective in disease modifying antirheumatic drug (DMARD) resistant cases of amyloidosis, there are yet patients whose disease does not respond to that treatment.3 ,4

We searched for reports on tocilizumab (TCZ), an anti-interleukin-6 receptor (anti-IL-6R) antibody, as treatment for reactive amyloidosis registered in the PUBMED. Altogether six such cases were found with encouraging treatment results.3–8 All the reports are based on single case reports with limited follow-up data. We present over 1-year experience on five patients who were treated with the drug for this indication. One of the patients was included in our preliminary report of the effect of …

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