Effect Of IL-6 Receptor Inhibitor Tocilizumab On Hemoglobin In Patients With Rheumatiod Arthritis:a Meta-analysis

Background Rheumatoid arthritis(RA)is a systemic autoimmune disease characterized by high morbidity and high mortality,about 30%-70% of RA patients are complicated with anemia.Tocilizumab is a kind of IL-6 receptor inhibitor,and its efficacy in the treatment of RA has been recognized.However,the effects of Tocilizumab(TCZ)on hemoglobin levels in RA patients are divergent.In this study,the effect of tocilizumab on RA patients with anemia was evaluated by searching relevant literature on the effect of tocilizumab on hemoglobin levels in RA patients.Objective To assess the effect of tocilizumab on hemoglobin levels in RA patients.Method The computer searches Pub Med,Embase,Web of science,CBM,Wanfang database,CNKI,Weipu journal database,and collects titles,abstracts,and keywords containing: "Rheumatoid Arthritis","Arthritis,Rheumatoid","tocilizumab","Interleukin-6 "," IL-6 "," IL-6 receptor inhibitor "," Anemia "," Hemoglobins " and " Hemoglobin " and other English search terms and " rheumatoid arthritis "," rheumatoid arthritis "," Tocilizumab "," Yamelo "," Interleukin-6 inhibitor "," Interleukin-6 antagonist "," IL-6 inhibitor "," IL-6 antagonist "," Anemia " And "hemoglobin" and other Chinese search terms.English literature search uses a combination of subject words and free words.Results Seven eligible articles were included,and a total of 2442 RA patients were included.The combined effect of hemoglobin in the test group and the control group 4 weeks after treatment was MD = 0.31,95% CI(0.22,0.40);the hemoglobin combined effect amount at week 8 after treatment was MD = 0.56,95% CI(0.15,0.98);12 weeks after treatment,the hemoglobin combined effect amount MD = 0.30,95% CI(0.21,0.40);16 weeks after treatment,the hemoglobin combined effect amount MD = 0.29,95% CI(0.20,0.39);The hemoglobin pooling effect at 24 weeks after treatment was MD = 0.28,95% CI(0.18,0.37).The combined effect amount results were statistically significant.The combined effect amount before and after CRP treatment is MD =-0.35,95% CI(-0.43,-0.26),the combined effect amount before and after ESR treatment was MD =-0.23,95% CI(-0.37,-0.08),and the combined effect amount was statistically significant.No publication bias was detected.Conclusion The effect on the hemoglobin level of patients with rheumatoid arthritis complicated by anemia,the effect of increasing the hemoglobin in the IL-6 receptor inhibitor(tocilizumab)group was better than the control group.