Checking for flare when on tocilizumab

[Devoid]

Hi has anyone come across how they can check inflammation levels when on tocilizumab?

[PMRpro]

They can do IL-6 levels but it isn't widely available and is expensive. Most go by the symptoms.

[Devoid in reply to PMRpro]

Hi I’ve been generally off for a few days, the GP has emailed rheumatology urgent yesterday but no response and they have stopped the patient help line indefinitely! Had bloods yesterday in case I had to restart pred.As expected crp normal but I did think it was interesting that feritin was elevated. The doctor hadn’t commented on this but I looked into it and it can be linked to inflammation.Not sure what to think

[PMRpro in reply to Devoid]

Ferritin is another acute phase reactant - like ESR and CRP.

You know that only half of patients on TCZ get off pred altogether? There can be 3 mechanisms causing inflammation in GCA - TCZ only has an effect on 1, production of IL-6. If your GCA has one or both of the other two involved, you still need pred. Biologics are extremely specific in their action - one thing, and one alone ...

[Devoid in reply to PMRpro]

I’m aware of that , do you think I would have gone this long before a flare ( stopped pred February) or is that like how long is the piece of string 😧

[PMRpro in reply to Devoid]

I fear it may be ...

[Devoid in reply to PMRpro]

Thanks again for your support and knowledge

[Sophiestree in reply to Devoid]

How long from starting the TCZ did you take to get off pred?

[Devoid in reply to Sophiestree]

15 months