Summary

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• This summary is based on the review of 36 systematic review(s)/meta-analysis(es). ^[1-34]
• In Polymyalgia Rheumatica (PMR) and Giant Cell Arteritis (GCA), tocilizumab is approved as a corticosteroid-sparing therapy specifically for GCA.
• In Systemic Juvenile Idiopathic Arthritis (JIA), tocilizumab showed no significant differences in adverse events compared to placebo in a network meta-analysis. Canakinumab achieved the highest ACRpedi30 response rate.
• In Rheumatoid Arthritis (RA), tocilizumab demonstrated high efficacy in achieving ACR20 (DAS28) (ORs ranging between 3.05 and 5.61) and ACR50 response rates, particularly in monotherapy, compared to adalimumab. Combination therapy with methotrexate significantly improved outcomes.
• Tocilizumab demonstrated effectiveness in large vessel vasculitis, particularly in GCA.
• Tocilizumab's safety profile includes risks of infections and elevated lipid profiles but does not show a statistically significant increase in serious adverse events compared to other treatments. Specific adverse events include HBV (+) reactivation in RA patients without antiviral prophylaxis, ocular adverse events such as uveitis, and reactivation of herpes zoster virus. There is also an increased risk of abnormal liver function tests and infections. Tocilizumab’s safety is comparable to other biologics like sarilumab and adalimumab, with no significant differences in the incidence of adverse reactions.
• There is no population type or subgroup information available in the reviewed studies.