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Rheumatoid factor level increased by the toclizumab in rheumatoid arthritis patients with good clinical response and previous inadequate response to TNF inhibitors

The possible underlying mechanisms whereby IL-6 blocking therapy could lead to alterations of RF are not understood. It is known that IL-6 enhances the production of auto antibodies such as RF so these results are completely unexpected. Possible interactions between antibodies and cytokines are numerous. One additional possible explanation for these findings might be that blockade of IL-6 signalling by TCZ directly interferes with B cell diferentiation, germinal centre formation and subsequent autoantibody production. In the long term for RA patients with high RF levels anti TNT-IR B cell-depleting therapy might be a better choice.

: rheumatoid factor, tocilizumab, clinical response

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