Tocilizumab

Tocilizumab is a biological therapy and can be prescribed forrheumatoid arthritis（Roo-ma-toy-d arth-ri-tus），少年特发性关节炎（JIA）或者giant cell arteritis.

如果您患有类风湿关节炎，或其他自身免疫性或炎症性疾病，则体内可能有太多的IL-6蛋白。这会导致炎症和损害，在儿童中会引起发烧和皮疹。Tocilizumab通过阻止IL-6的影响来起作用。

如果要工作的话，Tocilizumab将在三到六个月内工作。有些患者在开始治疗后两周可能会感觉更好。

It may be the first biological therapy you’re given, or you may have tried others first, such as an anti-TNF treatment or rituximab.

如果：

• 你r arthritis isn’t active
• 你have a severe infection
• 你have not tried other treatments for your condition
• 您怀孕或母乳喂养。

Your doctor may decide not to prescribe tocilizumab if:

• 你keep getting infections
• 您患有癌症
• 您患有肝病或血液检查表明该药物可能会影响您的肝脏
• 你have a low number of white blood cells or platelets
• 你have a history of diverticulitis (die-vuh-tick-yoo-lie-tus)
• 你have certain heart problems.

您的医生会检查您以前是否暴露于结核病（TB）。在开始Tocilizumab之前，您可能需要对潜在结核病进行治疗。但是，如果您是系统性发作JIA的孩子，这可能不会做到。

If you’re an adult, you will also be screened for hepatitis B and C infection. Tocilizumab may increase the risk of hepatitis B starting up again, although very few cases have been reported. If you have a history of hepatitis, the decision to use tocilizumab may involve a discussion between you, yourrheumatologist（Roo-ma-tolo-jist）和肝脏医生。

If you’re an adult, you may have a chest x-ray before starting tocilizumab. You will also have a chest x-ray six months after starting treatment.

如何服用Tocilizumab

	类风湿关节炎	Giant cell arteritis	系统性贾	Polyarticular JIA
皮下注射	Yes – this is done once a week	是的 - 每周一次，在大腿或上臂	是的，如果12岁或以上；once a week or once every 2 weeks depending on body weight	是的，如果12岁或以上；每2或3周一次，具体取决于体重
静脉输注	Yes – this takes about an hour once every four weeks	不	Yes – every two weeks	是的 - 每四个星期

An intravenous (in-truh-vee-nus) infusion is when the drug is given through a drip into a vein.

使用预填充的注射器或笔装置将药物注射在皮肤下方时，皮下（kyoo-tay-nee-us）注射是在皮肤下注射的。

如果您已经有输注并想切换到注射，请与您的联系风湿病团队.

Because it’s a long-term treatment, it’s important to keep taking tocilizumab:

• even if it doesn’t seem to be working at first
• 即使您的症状开始改善，这将有助于控制您的病情。

However, this may change if you experience side effects.

The most common side effects are:

• 咳嗽或喉咙痛，鼻子被阻塞或流鼻涕
• 头痛或头晕
• 口腔溃疡
• high blood pressure
• 高胆固醇血症（血液中的胆固醇升高）
• 过敏反应 - 这可能包括肌肉酸痛，感觉不呼吸，胸部紧，喘息和高温
• 体重增加或脚踝肿胀
• 皮疹，感染或瘙痒
• 胃部刺激或腹痛。

已显示毒珠单抗会增加类风湿关节炎患者感染的风险。这些包括：

• upper respiratory tract infections
• 唇疱疹
• 带状疱疹
• skin infections - such as cellulitis (sel-lyu-lie-tus)
• 肺炎（新的纽约人）。

It is important that any infections are treated as soon as possible.

If you think you may have an infection, or you become unwell in any way, contact your风湿病团队或您的GP。服用Tocilizumab的人并不总是表现出通常的感染迹象，例如高温，因为它们被Tocilizumab阻塞。如果您不确定，请寻求建议。

如果您处方了抗生素，请与风湿病团队交谈，并取消您的Tocilizumab输液。暂时停止注射，直到感染清除为止。

如果您患有艾滋病毒，丙型肝炎或丙型肝炎，重要的是要讨论与您的托氏菌的潜在风险rheumatologist.

Cholesterol and liver function

Tocilizumab可以增加您的胆固醇水平，也可能影响肝功能测试。结果，服用Tocilizumab时，您需要每四个星期进行一次血液检查。

头晕

You may feel dizzy while taking tocilizumab. This could affect your ability to drive and perform other tasks.

Tocilizumab may be prescribed along with other drugs, including甲氨蝶呤(mee-thoh-treks-ate) and glucocorticoids (steroids). Check with your doctor before starting any new medications, and remember to mention you’re on tocilizumab if you’re treated by anyone other than your usual风湿病团队.

In rheumatoid arthritis

如果：

• 您的关节炎很严重
• 你r arthritis has not responded to intensive therapy with a combination of conventionaldmards.

Usually tocilizumab is prescribed in combination with methotrexate, but it can be used on its own if you’re unable to take methotrexate.

在巨细胞动脉炎中

建议将托妥珠单抗作为治疗的选择giant cell arteritisin adults if used with steroids that are gradually decreased. It can also be used by itself after glucocorticoids have been stopped. However, this is only the case if:

• 您的疾病尚未单独反应类固醇，或在接受类固醇治疗后复发
• 你have not already received tocilizumab for your giant cell arteritis.

Tocilizumab should not be continued for more than one year in people with giant cell arteritis.

It’s recommended that you carry a biological therapy alert card, so that anyone treating you will know you’re on tocilizumab. You can get a card from your rheumatology department.

没有特殊的理由避免服用Tocilizumab时酒精。但是，政府指南说，男人和女人都应每周喝不超过14个单位的酒精，并且您应该在一周中散布这些酒，而不是一口气。

您可以在www.drinkaware.co.uk.

通常建议使用托珠单抗的人避免使用以下实时疫苗：

• 黄热病
• varicella-zoster (varry-sell-er zos-ter)
• typhoid
• rotavirus
• MMR（麻疹，腮腺和风疹）
• BCG。

If you're already on tocilizumab, speak to your doctor before having any of the above vaccinations. Sometimes a live vaccine may be necessary, such as rubella vaccination in women of child-bearing age.

肺炎球菌（全木库克）疫苗可预防最常见的肺炎原因和每年的流感疫苗。

在可能的情况下，应在开始托库珠单抗之前对儿童和带状疱疹接种的任何常规疫苗接种。

If you take tocilizumab intravenously, it should be stopped at least four weeks before surgery. If you take tocilizumab subcutaneously (by injection or injection pen), it should be stopped at least two weeks before surgery.

与您的医疗团队联系以获取更多详细信息。

如果您打算尝试婴儿，如果您怀孕或考虑母乳喂养，请与风湿病学家交谈。

Tocilizumab should be avoided during pregnancy, unless essential, as it’s not yet known how the drug can affect an unborn baby.

如果您在怀孕的早期阶段服用了托曲珠单抗，则不太可能有害。

您应该在服用Tocilizumab时可以接受母乳喂养，但是这项研究是有限的，因此最好与您的医生讨论这一点是个好主意。

There is currently no evidence that men must stop tocilizumab if they are trying to father a baby.