Trial reportClinical rheumatology2018
Tocilizumab reduces complement C3 and C4 serum levels in rheumatoid arthritis patients.
Trial report in Clinical rheumatology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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.
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.
Who cites it
20 citing papers in PubMed, 26 citations in OpenAlex.
- Therapeutic Applications of Immunobiologics in Autoimmune and Inflammatory Diseases.Pharmaceutics · 2026Review
- Changes in Blood Cells and Complements During Relapse Prevention Therapies for Aquaporin-4 Antibody-Positive Neuromyelitis Optica Spectrum Disorder.International journal of molecular sciences · 2026Article
- First-Line Tocilizumab Monotherapy for Juvenile Systemic Sclerosis With Interstitial Lung Disease: A Case Report.Case reports in rheumatology · 2026Article
- Functional Roles of the Complement Immune System in Cardiac Inflammation and Hypertrophy.International journal of molecular sciences · 2025Review
- Hypocomplementemia dynamics during tocilizumab therapy in systemic juvenile idiopathic arthritis: a retrospective longitudinal study.Frontiers in immunology · 2025Article
- Tocilizumab modulates the activity of the classical and alternative complement pathways in rheumatoid arthritis patients.Frontiers in immunology · 2025Article
- Complement Immune System in Pulmonary Hypertension-Cooperating Roles of Circadian Rhythmicity in Complement-Mediated Vascular Pathology.International journal of molecular sciences · 2024Review
- Systemic Immune Factors and Risk of Allergic Contact Dermatitis: A Bidirectional Mendelian Randomization Study.International journal of molecular sciences · 2024Article
- The effect of immunosuppressive therapies on the endothelial host response in critically ill COVID-19 patients.Scientific reports · 2024Article
- Mechanistic and therapeutic links between rheumatoid arthritis and diabetes mellitus.Clinical and experimental medicine · 2023Review
- Dietary Supplementation with Boswellia serrata, Verbascum thapsus, and Curcuma longa in Show Jumping Horses: Effects on Serum Proteome, Antioxidant Status, and Anti-Inflammatory Gene Expression.Life (Basel, Switzerland) · 2023Article
- Overview on the Link Between the Complement System and Auto-Immune Articular and Pulmonary Disease.Open access rheumatology : research and reviews · 2023Review
- Analysis of Hepatic Lipid Metabolism and Immune Function During the Development of Collagen-Induced Arthritis.Frontiers in immunology · 2022Article
- Immunosuppressive Agents and Infectious Risk in Transplantation: Managing the "Net State of Immunosuppression".Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Review
- Tocilizumab for massive refractory pleural effusion in an adolescent with systemic lupus erythematosus.Pediatric rheumatology online journal · 2021Article
- Serum complement C3 and αHeliyon · 2021Article
- Complement C4, Infections, and Autoimmune Diseases.Frontiers in immunology · 2021Review
- Tocilizumab-induced immunocomplex glomerulonephritis: a report of two cases.CEN case reports · 2020Article
- Tocilizumab treatment effectively improves coronary artery involvement in patients with Takayasu arteritis.Clinical rheumatology · 2020Article
- Complement-Mediated Events in Alzheimer's Disease: Mechanisms and Potential Therapeutic Targets.Journal of immunology (Baltimore, Md. : 1950) · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Tocilizumab, an anti-interleukin-6 receptor monoclonal antibody, is known to be able to rapidly reduce acute phase reactants. Although complement components are part of the acute phase, no data are available on a possible effect of tocilizumab on complement proteins. Serum levels of complement components C3 and C4 were retrospectively assessed in 19 consecutive rheumatoid arthritis patients eligible for tocilizumab treatment. Tocilizumab was found to reduce all known acute phase reactants, including C3 and C4 levels. C3 and C4 were found to decrease as early as 4 weeks after the first tocilizumab infusion. On average, C3 decreased by 24.02, 27.35, 33.62, and 32.81%, as compared to pre-treatment values, after 1, 3, 6, and 12 months of therapy, respectively; likewise, C4 decreased by 44.74, 43.40, 54.33, and 54.56% at the same time points with respect to pre-treatment values. A discrete proportion of patients (38.46 and 30.76% for C3 and C4, respectively) displayed subnormal complement serum levels early (4 weeks) after initiation of tocilizumab treatment, which raised suspicion for complement consumption. However, no circulating immunocomplexes were found nor did any patient ever display clinical features of immunocomplex disease during a median follow-up of 38 months. After 12 months of therapy, 68.75 and 56.25% of patients had abnormally low C3 and C4 serum levels, respectively. Reduction in C3 and C4 serum levels should be included among the anti-inflammatory effects exerted by tocilizumab and are thus to be considered as an expected outcome of the mechanism of action of this drug.
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What OpenQuestion holds
Registered trials
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.