Avtozma (tocilizumab-anoh) dosage and usage

Avtozma (tocilizumab-anoh) is a biologic indicated for a variety of diseases. It is used primarily to treat adult patients with moderately to severely active rheumatoid arthritis (RA) who have not responded to one or more antirheumatic drugs. In addition, Avtozma is also indicated for the treatment of giant cell arteritis (GCA) in adults, as well as polyarticular juvenile idiopathic arthritis (PJIA) and systemic juvenile idiopathic arthritis (SJIA) in patients 2 years of age and older. Meanwhile, in the treatment of COVID-19, Avtozma is also an effective treatment option for hospitalized adult patients who are receiving systemic corticosteroids and require supplemental oxygen or mechanical ventilation. Its usage and dosage include the following:

1. Medication management:

(1) It is not recommended to use Avtozma concurrently with biological DMARDs; due to the possibility of increased immunosuppression and increased risk of infection, tocilizumab products have not been studied in combination with biological DMARDs such as TNF antagonists, IL-1R antagonists, anti-CD20 monoclonal antibodies, and selective costimulation modulators. Avoid using Avtozma with biologic DMARDs.

(2) Baseline laboratory evaluation before treatment: Obtain and evaluate a baseline complete blood count (CBC) and liver function tests before treatment. RA, GCA, PJIA, and PJIA recommend that patients with an absolute neutrophil count (ANC) less than 2,000/mm3, a platelet count less than 100,000/mm3, or an ALT or AST greater than 1.5 times the upper limit of normal (ULN) should not use Avtozma. COVID-19—It is recommended that patients with an absolute neutrophil count (ANC) less than 1,000/mm3, a platelet count less than 50,000 mm3, or an ALT or AST greater than 10 times the ULN should not use Avtozma.

2. Recommended dosage:

(1) Rheumatoid Arthritis (RA): The recommended intravenous dose of Avtozma for treatment of adults is 4 mg per kilogram every 4 weeks, then increased based on clinical response to 8 mg per kilogram every 4 weeks. The recommended subcutaneous dosing regimen for the treatment of RA patients weighing <100 kg is 162 mg subcutaneously every other week, increasing to once weekly based on clinical response. The dose for patients weighing 100 kg or more is 162 mg subcutaneously weekly.

(2) Giant cell arteritis (GCA): The recommended intravenous dose of Avtozma in adult patients is a single 60-minute intravenous infusion of 6 mg/kg every 4 weeks, combined with a tapering course of glucocorticoids. For adult patients with GCA, the recommended subcutaneous dose is 162 mg administered subcutaneously once weekly in combination with tapering courses of glucocorticoids.

（3) Polyarticular Juvenile Idiopathic Arthritis (PJIA): For patients weighing less than 30kg, the recommended intravenous dose is 10mg/kg, once every 4 weeks, as a 60-minute intravenous infusion. The dose for patients weighing 30 kg or more is 8 mg per kilogram. The recommended subcutaneous dosage regimen for PJIA patients weighing <30 kg is 162 mg every 3 weeks. The dose for patients weighing 30 kg or more is 162 mg every two weeks.

(4) Systemic juvenile idiopathic arthritis (SJIA): For patients weighing <30kg, the recommended intravenous dose is 12mg/kg, once every 2 weeks, as a single intravenous infusion over 60 minutes. The dose for patients weighing 30 kg or more is 8 mg per kilogram. The recommended subcutaneous dosage regimen for SJIA patients weighing <30 kg is 162 mg every 2 weeks. The dose for patients weighing 30 kg or more is 162 mg once weekly.

(5) COVID-19: The recommended dose of Avtozma for the treatment of adult patients is 8 mg/kg, a single 60-minute intravenous infusion. If clinical signs or symptoms worsen or do not improve after the first dose, another infusion of Avtozma may be given at least 8 hours after the first infusion.

Reference materials:https://www.rxlist.com/avtozma-drug.htm