Tocilizumab for the treatment of polyarteritis nodosa: a systematic literature review.

We read the paper by Rimar et al 1 in your journal with great interest. They reported the case with refractory polyarteritis nodosa treated with tofacitinib, a janus kinase inhibitor, successfully. As shown in their paper, recent advances in the era of biologic agents have improved the management of difficult-to-treat cases dramatically. Considering that tofacitinib blocks interleukin (IL)-6-mediated signalling pathway through inhibiting janus kinase 1, inhibiting IL-6 cascade may also be effective in polyarteritis nodosa. In this regard, tocilizumab, a biologic agent targeting IL-6 receptor, has shown its efficacy in a variety of diseases such as rheumatoid arthritis, adult-onset Still’s disease, large-vessel vasculitis and Behcet’s disease.2–5 Although the precise pathogenesis of polyarteritis nodosa remains unclear, serum IL-6 levels correlate with disease severity, suggesting the involvement of IL-6 in the disease process.6 Therefore, we assume that tocilizumab may benefit polyarteritis nodosa as a therapeutic option. To investigate the effectiveness and safety profile of tocilizumab in patients with polyarteritis nodosa, we performed a systematic literature …