Objective · To investigate the efficacy and safety of tocilizumab in combination with methotrexate (MTX) for the treatment of refractory rheumatoid arthritis (RA) with moderate to severe activity. Methods · Ten patients with refractory active RA underwent tocilizumab injection in combination with oral MTX. Changes in indexes such as tender joint count (TJC), swollen joint count (SJC), blood sedimentation (ESR), C reactive protein (CRP), disease activity score 28 (DAS28), simplified disease activity index (SDAI), and clinical disease activity index (CDAI) were observed before (baseline), 12 weeks, and 24 weeks after treatment and adverse reactions were documented. Results · After treatment for 12 and 24 weeks indexes including joint symptoms, signs, ESR, DAS 28, CDAI, and SDAI significantly improved than baseline(P<0.05). No adverse reactions such as leukopenia, cardiac insufficiency, and severe infection were observed.
Conclusion · Tocilizumab can rapidly and significantly improve clinical symptoms, signs, active indexes, and arthritis scores for patients with refractory active

RA.