Tocilizumab ( adalimumab or methotrexate ) is a natural product, a monoclonal antibody aimed at intracellular folate metabolism and mainly used as immunosuppressant in rheumatoid arthritis (1).

Other applications.

Treatment with Tocilizumab has significantly reduced the activity of Takayasu arteritis disease with coronary artery involvement (2) and, administered intravenously in a patient with subacute memory, balance alteration, behavioural and mood changes and seizures, has demonstrated efficacy in autoimmune limbic encephalitis associated with anti-CASPR2 antibodies (3).

During the serious COVID-19 epidemic, prof. Paolo Antonio Ascierto from Ospedale Cotugno of Naples in March 2020 used Tocilizumab in an intubated patient who was able to independently breathe.

Contraindications

Numerous cases have been observed of patients suffering from chronic inflammatory disease who, treated with biological drugs (adalimumab), reported induced psoriasis (4).

References__________________________________________________

(1) Cimmino MA, Parodi M, Barbieri F, et al. Dynamic Contrast-Enhanced MRI Confirms Rapid And Sustained Improvement Of Rheumatoid Arthritis Induced By Tocilizumab Treatment: An Italian Multicentre Study. Biologics. 2020;14:13–21. Published 2020 Feb 11. doi:10.2147/BTT.S209873

(2) Pan L, Du J, Liu J, et al. Tocilizumab treatment effectively improves coronary artery involvement in patients with Takayasu arteritis [published online ahead of print, 2020 Mar 6]. Clin Rheumatol. 2020;10.1007/s10067-020-05005-7. doi:10.1007/s10067-020-05005-7

(3) Benucci M, Tramacere L, Infantino M, et al. Efficacy of Tocilizumab in Limbic Encephalitis with Anti-CASPR2 Antibodies. Case Rep Neurol Med. 2020;2020:5697670. Published 2020 Feb 14. doi:10.1155/2020/5697670

(4) Montolio Chiva L, Martínez Ferrer À, Mateu Puchades A, Campos Fernández C, Narváez Garcia J, Alegre Sancho JJ. Psoriasis Induced by Biological Therapy [published online ahead of print, 2020 Mar 4]. Psoriasis inducida por terapia biológica [published online ahead of print, 2020 Mar 4]. Reumatol Clin. 2020;S1699-258X(20)30019-X. doi:10.1016/j.reuma.2019.12.005