Synonyms: Actemra® | R-1569 | RG-1569 | RHPM-1 | RoActemra®

tocilizumab is an approved drug (Japan (2005), EMA (2009), FDA (2010))

Compound class: Antibody

Comment: Tocilizumab is an anti-IL-6 receptor mAb, with immunosuppressive action [12] that is approved for chronic autoimmune indications.
Annotated peptide sequences for this antibody are available from its IMGT/mAb-DB record.

SARS-CoV-2 and COVID-19: In early March 2020, China's National Health Commission issued guidance that allows use of tocilizumab to treat patients with serious COVID-19-induced lung damage. Tocilizumab is predicted to mitigate against the uncontrolled immune response that is triggered by SARS-CoV-2 infection [4,16] in some patients and which leads to potentially life-threatening damage to the lungs and other organs. Clinical trials are beginning to reveal outcomes (Oct 2020), but the level of benefit remains unclear [5-6,13-14] and requires further investigations. Differences between the studies (timing of treatment, severity of disease at initiation of treatment etc.) make it difficult to compare results and form a solid conclusion. In early January 2021, data was reported from a small cohort of severely ill, mechanically ventilated COVID-19 patients in the REMAP-CAP trial (NCT02735707) who received tocilizumab. The information released (data not yet peer-reviewed) suggested that tocilizumab (compared to standard care) significantly reduced mortality and that patients treated with this mAb were able to leave intensive care 7-10 days earlier than those who didn't receive the drug. This effect appears to be in addition to the clinical benefit conferred by dexamathasone. As a result of this latest report, the UK Department of Health and Social Care was set to issue updated guidance (on 8th Jan; link to gov.uk press release) which will encourage NHS trusts across the UK to immediately begin using existing stocks of tocilizumab in their treatment of critically ill COVID-19 patients in ICUs.

Biosimilars:

Name	Trade name	Company	Clinical Phase	Indications
tocilizumab-bavi; BIIB800	Tofidence	Biogen	Approved (2023)	As per reference agent
QX003S	n/a	Qyuns Therapeutics	1 [18]	inflammatory/immune diseases
tocilizumab-aazg; MSB11456	Tyenne	Fresenius Kabi	Approved (2024)	As per reference agent
LZM008	n/a	Livzon Mabpharm	1 [3]	inflammatory/immune diseases