Abstract

Background: ILD is the most common pulmonary complication in patients with RA. Certain drugs, such as methotrexate, have been associated with the progression of ILD. Therefore, drugs used for treating RA with ILD should be administered carefully.

Aims: This study aimed to evaluate the safety of tocilizumab on ILD in patients with RA.

Methods: Subjects were 34 patients (17 men, 17 women, mean age 69.4 years) with both RA and ILD. The effect of tocilizumab was evaluated before, 2 months after, and 6 months after administration.

Results: Mean levels of matrix metalloproteinase-3 (MMP-3), which is a biomarker of RA disease activity, were 380 ± 370, 214 ± 216, and 208 ± 245 ng/mL, respectively. Significant differences were observed between before and after administration of tocilizumab (before vs 2 months: p<0.05, before vs 6 months: p<0.05). Mean levels of Krebs von den Lungen-6 (KL-6) were 555 ± 267, 560 ± 222, and 528 ± 224 U/mL, respectively. Significant differences were observed between before and after administration of tocilizumab (before vs 6 months: p<0.05, 2 months vs 6 months: p<0.01). Chest computed tomography (CT) revealed no differences between before and 1 year after administration in 22 patients who were performed the follow up CT one year after administration.

Conclusions: The disease activity of RA was significantly improved by administration of tocilizumab, and ILD did not progress. In patients with both RA and ILD, tocilizumab could be administrated safely without progression of ILD.