Rheumatoid Arthritis & IL6

Several rheumatoid arthritis studies have shown that tocilizumab (TCZ) may be as effective as monotherapy when compared to combination therapy (methotrexate plus TCZ), including the ACT-RAY, ACT-SURE and FUNCTION clinical trials.

Unlike the anti-TNFs in RA, where combination with MTX is superior to either agent alone, Tocilizumab (TCZ; anti-IL6) is superior to MTX, and the combination was not statistically better than TCZ alone. This is a boon for patients who tolerate MTX poorly.
However, the SURPRISE Study suggests that combination TCZ+MTX works faster and better in achieving RA remission and in prevention of joint damage (Xray progression), especially in those with more aggressive disease.