This page contains a brief description that does not cover the medication. For more information read the review in Felleskatalogen.no for the respective drug.

Definition

RoActemra is an Biological drug which inhibits the cytokine interleukin-6 (IL-6) in the immune system. RoActemra is used to treat rheumatic diseases, either as a syringe (subcutaneous, sc) or injection (intravenously, iv).

Before start of treatment

• X-ray or CT examination of lungs
• Disease history
  • Exclude signs of current infections
    • Diverticulitis in the colon
    • Hepatitis B, Hepatitis C, HIV, Tuberkulosis (Tbc)
  • Tbc screening (IGRA test)
  • Cancer
    • Previous or current cancer (may be a contraindication)
• Vaccination (pneumococci, influenza)
• Set a goal for treatment

 Dosage

• Adults (usually)
  • Subcutaneous dose 162mg / week
  • iv 8 mg / kg every X. week
• Children get the dose adjusted to body weight

Prescription

• H-prescription which is covered by the patient's health trust

Measurement of serum concentration

• Tocilizumab, Oslo University Hospital on their own requisition
• Reference range of tocilizumab in blood sample (bottom concentration just before the next infusion): Please see anx.no (tocilizumab)

Medical checkup / follow-up

• Infections must be excluded (although CRP is normal)
• CRP is (almost) always normalized and the sedimantation rate (ESR) lower, but the changes do not always correlate with the treatment response
• Antibodies are rarely formed
  • Measurement of drug concentration in blood can be used to assess drug effect (reference: Kneepkens EL, 2017)

Patient information

• The Norwegian Medical Association
• UpToDate (American side)

Medications, BINDEVEVSSYKDOMMER.no

• Bindevevssykdommer.no
• Vaskulitt.no