Two in vitro studies showed that TCZ-reversed IL-6 induced reduction of CYP isozymes. Appropriate articles were further screened based on full-text review to select only those reporting IL-6, TCZ and their potential interaction with CYP-metabolized drugs. Our search was conducted in MEDLINE, EMBASE, Web of Science, FDA and EMEA websites for in vitro and in vivo studies, clinical trials and reviews mentioning TCZ and CYP on the basis of the title and abstract. Due to the increasing use of TCZ, we undertook a systematic literature review to explore such interactions. This may lead to reduced bioavailability of CYP-metabolized drugs. As up-regulation of IL-6 reduces the activity of cytochrome P450 (CYP) enzymes, blockade of this cytokine may enhance CYP function. Interleukin 6 (IL-6) plays a central role in the immunopathogenesis of rheumatoid arthritis (RA) and tocilizumab (an anti-IL-6 receptor antibody) has been shown to be effective in the treatment of the condition.
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