Evidence map›Paper›PMID 29090685›Full record

Trial reportNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology2018

A Randomized, Double-Blind, Placebo-Controlled Clinical Trial of Tocilizumab, An Interleukin-6 Receptor Antibody, For Residual Symptoms in Schizophrenia.

Ragy R Girgis, Adam Ciarleglio, Tse Choo, Gregory Haynes, Joan M Bathon, Serge Cremers, Joshua T Kantrowitz, Jeffrey A Lieberman, Alan S Brown

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
64citing papers in PubMed, 4 pooled it
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

64 citing papers in PubMed, 4 syntheses or guidelines pooled it, 122 citations in OpenAlex.

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  10. Peripheral complement C4 protein in schizophrenia: Association with gene copy number and immune cell subtypes.Proceedings of the National Academy of Sciences of the United States of America · 2026
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4 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Ragy R GirgisDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Adam CiarleglioDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Tse ChooDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Gregory HaynesDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Joan M BathonDepartment of Medicine, Columbia University, New York, NY, USA.
Serge CremersDepartment of Pathology, Columbia University, New York, NY, USA.
Joshua T KantrowitzDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Jeffrey A LiebermanDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Alan S BrownDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
New York State Psychiatric InstituteColumbia University · USNew York Psychoanalytic Society and Institute · USNathan Kline Institute for Psychiatric Research · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Evidence from preclinical, epidemiological, and human studies indicates that inflammation, and in particular elevated interleukin-6 (IL-6) activity, may be related to clinical manifestations and pathophysiology of schizophrenia. Furthermore, studies in preclinical models suggest that decreasing IL-6 activity may mitigate or reverse some of these deficits. The purpose of this trial was to test whether an IL-6 receptor antibody, tocilizumab, would improve residual positive and negative symptoms and cognitive deficits in schizophrenia. We randomized 36 clinically stable, moderately symptomatic (i.e., Positive and Negative Syndrome Scale (PANSS) >60) individuals with schizophrenia to 3 monthly infusions of 8 mg/kg tocilizumab or placebo (normal saline). The primary outcome was effect at week 12 on the PANSS Total Score. Effects on the MATRICS, other PANSS subscales, Clinical Global Impression, and Global Assessment of Functioning were secondary outcomes. There were no observed treatment effects on any behavioral outcome measure. Baseline C-reactive protein (CRP) or cytokine levels did not predict treatment outcome, nor were there correlations between changes in these inflammatory markers and the measured outcomes. As expected, IL-6 and IL-8 increased, while CRP decreased, in the tocilizumab group compared with the placebo group. This study did not reveal any evidence that an IL-6 receptor antibody affects behavioral outcomes in schizophrenia. One potential explanation is the lack of capacity of this agent to penetrate the central nervous system. Additional trials of medications aimed at targeting cytokine overactivity that act directly on brain function and/or treatment in early-stage psychosis populations are needed.

Indexed as

Schizophrenic PsychologyAdultAntibodies, Monoclonal, HumanizedAntipsychotic AgentsBiomarkersCytokinesDouble-Blind MethodDrug Therapy, CombinationFemaleHumansMalePsychiatric Status Rating ScalesReceptors, Interleukin-6SchizophreniaTreatment OutcomeAntibodies, Monoclonal, HumanizedAntipsychotic AgentsBiomarkersCytokinesIL6R protein, humanReceptors, Interleukin-6tocilizumab

Identifiers

PMID29090685
PMCPMC5916349
OpenAlexW2766457141

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.