Evidence map›Paper›PMID 34015207›Full record

ArticleAsian spine journal2022

Improvements in Intractable Lumbar and LowerExtremity Symptoms after Systemic Administration of Tocilizumab, an Anti-interleukin-6 Receptor Antibody.

Takeshi Sainoh, Sumihisa Orita, Masayuki Miyagi, Miyako Suzuki-Narita, Yoshihiro Sakuma, Yasuhiro Oikawa, Go Kubota, Jun Sato, Yasuhiro Shiga, Kazuki Fujimoto and 25 more

Open access · diamondAbstract read
In one paragraph

Article in Asian spine journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 31% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Immune drivers of physiological and pathological pain.The Journal of experimental medicine · 2024
    Article
  3. Review
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

35 authors at 12 institutions in 1 country.

Takeshi SainohDepartment of Orthopaedic Surgery, Sainou Hospital, Toyama, Japan.
Sumihisa OritaDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Masayuki MiyagiDepartment of Orthopaedic Surgery, School of Medicine, Kitasato University, Sagamihara, Japan.
Miyako Suzuki-NaritaDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yoshihiro SakumaDepartment of Orthopaedic Surgery, Kanazawa Hospital, Yokohama, Japan.
Yasuhiro OikawaDepartment of Orthopaedic Surgery, Chiba Children's Hospital, Chiba, Japan.
Go KubotaDepartment of Orthopaedic Surgery, Chiba Prefectural Sawara Hospital, Katori, Japan.
Jun SatoDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yasuhiro ShigaDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Kazuki FujimotoDepartment of Orthopaedic Surgery, Kohnodai Hospital, Ichikawa, Japan.
Yawara EguchiDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Masao KodaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Yasuchika AokiDepartment of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Japan.
Tsutomu AkazawaDepartment of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
Takeo FuruyaDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Junichi NakamuraDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Hiroshi TakahashiDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Satoshi MakiDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Masahiro InoueDepartment of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Japan.
Hideyuki KinoshitaDepartment of Orthopaedic Surgery, Chiba Cancer Center, Chiba, Japan.
Masaki NorimotoDepartment of Orthopaedic Surgery, Toho University Sakura Medical Center, Sakura, Japan.
Takashi SatoDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Masashi SatoDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Masahiro SuzukiDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Keigo EnomotoDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Hiromitsu TakaokaDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Norichika MizukiDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Takashi HozumiDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Ryuto TsuchiyaDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Geundong KimDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Takuma OtagiriDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Tomohito MukaihataDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Takahisa HishiyaDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Seiji OhtoriDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Kazuhide InageDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Chiba University · JPTeikyo University Chiba Medical Center · JPUniversity of Tsukuba · JPChiba Cancer Center · JPChiba Hospital · JPChiba Prefectural Sawara High School · JPKanazawa Hospital · JPKitasato University · JPKohnodai Hospital, National Center for Global Health and MedicineSt. Marianna University School of Medicine · JPToho University · JPToyama City Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designProspective cohort study (open-label, single-arm, and non-blinded). PURPOSE: This study aims to determine the effects of systemic administration of tocilizumab, an anti-interleukin-6 (IL-6) receptor antibody on refractory low back pain and leg symptoms. OVERVIEW OF LITERATURE: IL-6 overexpression is associated with neuropathic pain pathogenesis, which is potentially followed by chronic low back pain, including leg pain and numbness. This finding suggest that inhibition of IL-6 at the site of pain or in the transmission pathway could provide novel therapeutic targets for chronic low back pain.

methodsThis prospective, single-arm study included 11 patients (eight men; mean age, 62.7 years) with ≥3-months' chronic pain history due to lumbar disease. Subcutaneous TCZ injections were administered twice, at a 2-week interval. We evaluated low back pain, leg pain, and leg numbness using numeric rating scales and the Oswestry Disability Index (ODI; baseline and 6 months postinjection); serum IL-6 and tumor necrosis factor-α levels (baseline and 1 month postinjection); and clinical adverse events.

resultsIntractable symptoms reduced after TCZ administration. Low back pain improved for 6 months. Improvements in leg pain and numbness peaked at 4 and 1 month, respectively. Improvements in ODI were significant at 1 month and peaked at 4 months. Serum IL-6 was increased at 1 month. IL-6 responders (i.e., patients with IL-6 increases >10 pg/mL) showed particularly significant improvements in leg pain at 2 weeks, 1 month, and 2 months compared with nonresponders. We observed no apparent adverse events.

conclusionsSystemic TCZ administration improved symptoms effectively for 6 months, with peak improvements at 1-4 months and no adverse events. Changing serum IL-6 levels correlated with leg pain improvements; further studies are warranted to elucidate the mechanistic connections between lumbar disorders and inflammatory cytokines.

Indexed as

AnalgesicChronic painInterleukin-6Low back painTocilizumab

Identifiers

PMID34015207
PMCPMC8873999
OpenAlexW3162072543

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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.