The role of tocilizumab in therapeutic strategies: experience from the Republic of Moldova and international practice

Abstract

Background. Tocilizumab, an anti-IL-6R monoclonal antibody has proven its efficacy in treating autoimmune diseases and cytokine storms caused by COVID-19. Analyzing the successes of this therapy in the Republic of Moldova and international practice may support the expansion and optimization of tocilizumab use. Objective(s). To review the experience of tocilizumab use in the treatment of autoimmune diseases and hyperinflammatory states in the Republic of Moldova, compared to international practice. Materials and methods. For this synthesis, medical articles from 2020-2025 referring to the use of tocilizumab in rheumatoid arthritis, COVID-19, giant cell arteritis, and Graves’ ophthalmopathy were selected through the PubMed, HINARI and Google Scholar databases, including 6 articles referring to clinical practice in the Republic of Moldova. Results. In severe forms of rheumatoid arthritis, tocilizumab reduced the DAS28 disease activity score by 42-59% and induced a remission rate of up to 58.7% during long-term therapy. A significant reduction in mean disease activity could be observed within <4 weeks from the first administration. In COVID-19 cases with a chest CT severity score indicating severe disease, tocilizumab was found to reduce mortality and the need for mechanical ventilation. In the case of several autoimmune diseases, such as giant cell arteritis and Graves’ ophthalmopathy, tocilizumab has been successfully used in cases resistant to firstline treatments. Conclusion(s). The literature review has shown the major contribution of tocilizumab biological therapy in adapting therapeutic strategies for multiple autoimmune diseases and the COVID-19 associated cytokine storm, with comparable Results. s obtained in the Republic of Moldova and international practice.