El-Haggar S M, Hegazy S K, Mustafa W, Khrieba M O
Clinical Pharmacy Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt.
Eur Rev Med Pharmacol Sci. 2023 Feb;27(4):1512-1521. doi: 10.26355/eurrev_202302_31392.
Refractory Status Epilepticus (RSE) is a neurologic emergency that carries a high risk of mortality and morbidity. Every year, there are about 200,000 cases in the United States, affecting people of all ages. This study aimed to investigate the possible immuno-modulatory effect of tocilizumab in RSE patients receiving conventional anti-epileptic drugs.
50 outpatients who fulfilled the inclusion requirements for RSE were recruited in this randomized, controlled, and prospective study. The patients were divided into two groups randomly (n=25); the control group received standard RSE treatment, consisting of propofol, pentobarbital, and midazolam, and the tocilizumab group received standard RSE treatment plus tocilizumab. A neurologist evaluated each patient at the beginning of the therapy and after 3 months. Before and after treatment, serum nuclear factor kappa B (NF-κB), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β) and serum electrolytes were assessed.
The tocilizumab group showed a statistically significant reduction in the level of assessed parameters in comparison with the control group.
Tocilizumab might be a novel adjuvant anti-inflammatory medication in managing RSE.
难治性癫痫持续状态（RSE）是一种神经系统急症，具有较高的死亡率和发病率风险。在美国，每年约有20万例病例，影响各年龄段人群。本研究旨在探讨托珠单抗对接受传统抗癫痫药物治疗的RSE患者可能的免疫调节作用。
本随机、对照、前瞻性研究招募了50名符合RSE纳入标准的门诊患者。患者被随机分为两组（n = 25）；对照组接受标准的RSE治疗，包括丙泊酚、戊巴比妥和咪达唑仑，托珠单抗组接受标准RSE治疗加托珠单抗。一名神经科医生在治疗开始时和3个月后对每位患者进行评估。在治疗前后，评估血清核因子κB（NF-κB）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）和血清电解质。
与对照组相比，托珠单抗组评估参数水平有统计学意义的降低。
托珠单抗可能是治疗RSE的一种新型辅助抗炎药物。
