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01-10-2012 | Original Article

Efficacy of epidural administration of anti-interleukin-6 receptor antibody onto spinal nerve for treatment of sciatica

Authors: Seiji Ohtori, Masayuki Miyagi, Yawara Eguchi, Gen Inoue, Sumihisa Orita, Nobuyasu Ochiai, Shunji Kishida, Kazuki Kuniyoshi, Junichi Nakamura, Yasuchika Aoki, Tetsuhiro Ishikawa, Gen Arai, Hiroto Kamoda, Miyako Suzuki, Masashi Takaso, Takeo Furuya, Gou Kubota, Yoshihiro Sakuma, Yasuhiro Oikawa, Tomoaki Toyone, Kazuhisa Takahashi

Published in: European Spine Journal | Issue 10/2012

Abstract

Introduction

Interleukin-6 (IL-6) is thought to play a crucial role in the radicular pain caused by lumbar spinal stenosis. However, efficacy of inhibition of IL-6 for sciatica in patients with lumbar spinal stenosis has not been clarified. The purpose of the current study was to examine the effect of the anti-IL-6 receptor monoclonal antibody, tocilizumab, on radicular pain by its epidural administration onto spinal nerves in patients with lumbar spinal stenosis.

Methods

Sixty patients with low back and radicular leg pain caused by spinal stenosis were investigated. In 30 patients, we infiltrated 2.0 mL of lidocaine and 80 mg of tocilizumab onto the affected spinal nerve, and 2.0 mL of lidocaine and 3.3 mg of dexamethasone were used in 30 patients. Low back pain, leg pain, and leg numbness were evaluated during 1 month after spinal nerve infiltration.

Results

Infiltration of tocilizumab was more effective than dexamethasone for leg pain (3 days, 1, 2, and 4 weeks), low back pain (3 days, 1, 2 and 4 weeks), and leg numbness (3 days, 1 and 2 weeks). No adverse event was observed in either group.

Conclusion

Our results indicate that the epidural administration of an anti-IL-6 receptor monoclonal antibody, tocilizumab, onto the spinal nerve produced reduction of radicular leg pain, numbness, and low back pain without adverse event. IL-6 may be one of the inducers of pain caused by spinal stenosis in humans.

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Title: Efficacy of epidural administration of anti-interleukin-6 receptor antibody onto spinal nerve for treatment of sciatica
Authors: Seiji Ohtori
Masayuki Miyagi
Yawara Eguchi
Gen Inoue
Sumihisa Orita
Nobuyasu Ochiai
Shunji Kishida
Kazuki Kuniyoshi
Junichi Nakamura
Yasuchika Aoki
Tetsuhiro Ishikawa
Gen Arai
Hiroto Kamoda
Miyako Suzuki
Masashi Takaso
Takeo Furuya
Gou Kubota
Yoshihiro Sakuma
Yasuhiro Oikawa
Tomoaki Toyone
Kazuhisa Takahashi
Publication date: 01-10-2012
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 10/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2183-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficacy of epidural administration of anti-interleukin-6 receptor antibody onto spinal nerve for treatment of sciatica

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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