Table of Contents
Understanding Actemra:
What is Actemra?
Actemra (tocilizumab) is an FDA-approved biological medicine administered through intravenous infusion or subcutaneous injection. It is utilized to treat patients with various conditions, including COVID-19, rheumatoid arthritis, giant cell arteritis, scleroderma, polyarticular or systemic juvenile idiopathic arthritis, and severe cytokine release syndrome.
Approval for COVID-19 Treatment:
Actemra received FDA approval for COVID-19 treatment on December 21, 2022, specifically for certain adult patients. Pediatric patients (2 to 18 years old) with COVID-19 can still access Actemra under emergency use authorization (EUA).
Mechanism of Action:
Actemra, a monoclonal antibody, inhibits interleukin-6 (IL-6), a protein that, when activated, triggers an overactive immune system, leading to inflammation and autoimmune disease symptoms. By blocking IL-6 receptors, Actemra is believed to reduce immune system overactivity, minimizing inflammation in autoimmune diseases.
Technical Mode of Action (MOA):
At a technical level, Actemra binds to IL-6 receptors (sIL-6R and mIL-6R), inhibiting IL-6-mediated signaling through these receptors. Interleukin-6 is a pro-inflammatory cytokine produced by various cell types.
Indications for Use:
Actemra is indicated for treating conditions such as rheumatoid arthritis, giant cell arteritis, systemic sclerosis-associated interstitial lung disease, polyarticular juvenile idiopathic arthritis, systemic juvenile idiopathic arthritis, cytokine release syndrome, and FDA-approved for hospitalized adult COVID-19 patients.
Warnings:
Actemra affects the immune system, increasing susceptibility to infections. Patients should contact their doctor if they experience symptoms like fever, chills, fatigue, cough, skin sores, diarrhea, weight loss, or burning during urination. It may also cause stomach or intestinal perforation and liver problems.
Before Treatment:
Patients allergic to Actemra or with signs of infection, tuberculosis, or recent travel are advised to inform their doctor. Tests for infections may be performed before starting Actemra. Individuals with active infections, liver disease, nerve-muscle disease, diabetes, HIV, cancer, or planned vaccines should inform their doctor.
Pregnancy and Breastfeeding:
Pregnant or breastfeeding individuals should consult their doctor. Actemra may affect vaccination schedules for newborns, and a pregnancy registry may track its effects on babies.
How is Actemra Administered?
Actemra should be used as prescribed. It can be injected under the skin or into a vein, typically every 1 to 4 weeks. The first subcutaneous dose is given instead of the next intravenous dose when transitioning. Live vaccines should be avoided during Actemra treatment.
Dosage Information:
Detailed dosage information is provided for conditions such as rheumatoid arthritis, giant cell arteritis, cytokine-associated toxicity, and juvenile idiopathic arthritis. Specific doses based on weight and age are outlined.
Missed Dose and Overdose:
Patients missing a dose should contact their doctor for instructions. Emergency medical attention is necessary for overdose situations.
Precautions During Treatment:
While using Actemra, patients should avoid live vaccines, proximity to sick individuals, and promptly report signs of infection, liver problems, or perforation. Side effects, including allergic reactions, severe stomach issues, bleeding, or unusual symptoms, should be reported to the doctor.
Drug Interactions:
Actemra may interact with other medications, especially those treating rheumatoid arthritis. Patients should inform their doctor about all medicines, including abatacept, etanercept, anakinra, and others.
This comprehensive overview covers Actemra, its indications, mechanisms, warnings, administration, dosage, and precautions for safe and informed use.