ArticleLife (Basel, Switzerland)2021
The Effect of Tocilizumab on Inflammatory Markers in Patients Hospitalized with Serious Infections. Case Series and Review of Literature.
Article in Life (Basel, Switzerland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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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.
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Who cites it
21 citing papers in PubMed, 32 citations in OpenAlex.
- Dynamic inflammation-based prognostication in acute-on-chronic liver failure: The COSSH-CAR model as a step forward in personalized risk stratification.World journal of hepatology · 2026Article
- Perioperative Management of Biologic and Targeted Synthetic DMARDs in Orthopedic Surgery: Balancing Infection Risk and Disease Control.Microorganisms · 2026Review
- Case Report: delayed recognition of pulmonary tuberculosis during immunosuppression for suspected connective tissue disease.Frontiers in medicine · 2026Article
- The efficacy and safety of tocilizumab in juvenile localised scleroderma patients: a retrospective cohort study in Eastern China.Advances in rheumatology (London, England) · 2025Article
- The Clinical Value of Inflammatory Indicators at the Time of Secondary Infection After Treatment With Tocilizumab: A Cross-Sectional Study.Health science reports · 2025Article
- Guidelines vs mindlines: a qualitative investigation of how clinicians' beliefs influence the application of rapid molecular diagnostics in intensive care.Antimicrobial agents and chemotherapy · 2025Article
- Trajectories and predictive significance of inflammatory parameters for clinical outcome in COVID-19 patients treated with tocilizumab.Infection · 2025Article
- A Review of the Impact of Sjögren's Syndrome and/or the Presence of Anti-Ro/SS-A Antibodies on Therapeutic Strategies for Rheumatoid Arthritis.Journal of clinical medicine · 2025Review
- Septic shock in the immunocompromised cancer patient: a narrative review.Critical care (London, England) · 2024Review
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- The Association of Procalcitonin and C-Reactive Protein with Bacterial Infections Acquired during Intensive Care Unit Stay in COVID-19 Critically Ill Patients.Antibiotics (Basel, Switzerland) · 2023Article
- Reduced C-reactive protein level at hospital admission in patients treated with Tocilizumab - An attention may be required.Heliyon · 2023Article
- Psoas and Mediastinal Abscesses during Intravenous Tocilizumab Treatment in Multicentric Castleman Disease.Internal medicine (Tokyo, Japan) · 2023Article
- The Association of Low CD4 Expression on Monocytes and Low CD8+ T-Cell Count at Hospital Admission Predicts the Need for Mechanical Ventilation in Patients With COVID-19 Pneumonia: A Prospective Monocentric Cohort Study.Critical care explorations · 2022Article
- Limited efficacy of tocilizumab in adult patients with secondary hemophagocytic lymphohistiocytosis: a retrospective cohort study.Orphanet journal of rare diseases · 2022Article
- Case of a Deep Neck Abscess During Treatment for COVID-19.The American journal of case reports · 2022Article
- Case Report: Lessons Learned From Subsequent Autologous and Allogeneic Hematopoietic Stem Cell Transplantations in a Pediatric Patient With Relapsing Polychondritis.Frontiers in immunology · 2022Article
- Systemic inflammatory responses after orthopedic surgery in patients with rheumatoid arthritis treated with tofacitinib.Clinical rheumatology · 2021Article
- Dexamethasone and tocilizumab treatment considerably reduces the value of C-reactive protein and procalcitonin to detect secondary bacterial infections in COVID-19 patients.Critical care (London, England) · 2021Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe human anti-IL-6 receptor antibody tocilizumab (TCZ) has been approved for the treatment of rheumatoid arthritis (RA) and giant cell arteritis (GCA). It is observed that CRP levels drop quickly after starting TCZ treatment. This may lead to misinterpretation of laboratory results when accessing the patient with infectious disease while on TCZ. We conducted this study to report cases treated with tocilizumab who developed serious infections with special reference to levels of CRP and to review the literature on the effect of tocilizumab on acute phase response (APR) during infections.
methodsThe files of RA and GCA patients hospitalized in the Tel Aviv medical center between 2009-2019 were reviewed. Cases of patients with RA and GCA treated with tocilizumab who were hospitalized due to severe infections were reviewed with special emphasis on the duration of treatment, type of infection, and APR.
resultsWe identified nine admissions. Seven patients were treated with tocilizumab for RA, two for GCA. The diagnosis was pneumonia in three cases, osteomyelitis in one, cellulitis in one, endocarditis due to Whipple disease in one, abscess of cervix uteri in one, meningitis in one, and perforated diverticulitis in one. The mean CRP levels on admission were 4.75 mg/L (normal range, up to 5 mg/L). All cases were diagnosed correctly on admission.
conclusionsCRP levels may not correctly reflect the severity of infectious diseases during tocilizumab treatment. Increased awareness of the masking effect of tocilizumab on the APR during infection is needed in order to avoid a delay in the diagnosis.
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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.