ArticlePloS one2013
Tocilizumab induced acquired factor XIII deficiency in patients with rheumatoid arthritis.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 27 citations in OpenAlex.
- A nomogram based on LASSO-logistic regression for predicting tocilizumab-associated hypofibrinogenemia in patients with rheumatic diseases.Frontiers in pharmacology · 2026Article
- Evaluation of tocilizumab-induced hypofibrinogenemia in rheumatology practice: a retrospective, real-life, single-center experience.Rheumatology international · 2024Article
- Acquired factor XIII deficiency: A scoping review.European journal of anaesthesiology and intensive care · 2023Review
- Tocilizumab-induced hypofibrinogenemia in patients with systemic-onset juvenile idiopathic arthritis.Scientific reports · 2023Article
- Expression of factor XIII originating from synovial fibroblasts and macrophages induced by interleukin-6 signaling.Inflammation and regeneration · 2023Article
- Tocilizumab in hospitalized patients with COVID-19: Clinical outcomes, inflammatory marker kinetics, and safety.Journal of medical virology · 2021Observational
- Is Real-World Evidence Used in P&T Monographs and Therapeutic Class Reviews?Journal of managed care & specialty pharmacy · 2020Article
- Spontaneous Spinal Epidural Hematoma During Simultaneous Tocilizumab and Warfarin Use in a Patient With Rheumatoid Arthritis: Is There a Drug Interaction Between Tocilizumab and Oral Anticoagulants?Archives of rheumatology · 2020Article
- Article
- Tocilizumab Effects on Coagulation Factor XIII in Patients with Rheumatoid Arthritis.Advances in therapy · 2019Article
- Is Real-World Evidence Used in P&T Monographs and Therapeutic Class Reviews?Journal of managed care & specialty pharmacy · 2017Article
- [Tocilizumab in giant cell arteritis].Zeitschrift fur Rheumatologie · 2017Article
- Tocilizumab-associated multifocal cerebral thrombotic microangiopathy.Neurology. Clinical practice · 2016Article
- Effects of Factor XIII Deficiency on Thromboelastography. Thromboelastography with Calcium and Streptokinase Addition is more Sensitive than Solubility Tests.Mediterranean journal of hematology and infectious diseases · 2016Article
- Coagulation Biomarkers and Mortality in Severe COVID-19: The Prognostic Value of Factor XIII Decline and Elevated D-Dimers.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Factor XIII is one of the twelve coagulation factors and also known as a fibrin-stabilizing factor. In 2012, we encountered a male RA patient with hemorrhagic factor XIII deficiency who had been treated with tocilizumab for two years. There are few reports regarding the relationship between tocilizumab (a humanized monoclonal antibody against the interleukin-6 receptor (IL-6R)) and factor XIII. We measured the factor XIII activity levels in the plasma of 40 RA patients (10 patients treated without biologics, 30 patients treated with biologics (15 patients treated with necrosis factor inhibitors and 15 patients treated with tocilizumab)) and 19 healthy controls. Consequently, the tocilizumab group exhibited lower levels than the other three groups according to the Steel-Dwass test (P<0.01). Furthermore, we compared the plasma factor XIII activity levels and the plasma factor XIII concentrations in the RA patients treated with biologics. Pearson's correlation test was used to assess the relationship between the factor XIII activity levels and the plasma factor XIII concentrations (r=0.449, P=0.019). According to the multiple regression analysis, the treatment with tocilizumab is an independent risk factor for plasma factor XIII reduction in RA patients. In conclusion, RA patients treated with tocilizumab, an IL-6R blocker, are at risk of developing acquired factor XIII deficiency. The mechanisms underlying the reduced factor XIII activity observed in RA patients treated with tocilizumab may result from the quantitative reduction in the plasma. These data imply that IL-6 plays an important role in maintaining the factor XIII activity level.
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