Sleep Disturbances and Interleukin 6 Receptor Inhibition in Rheumatoid Arthritis
Open accessAbstract
Objective.: Interleukin 6 (IL-6)-mediated interactions have been associated with sleep disturbances in healthy subjects. In this pilot study we examined whether administration of the IL-6 receptor antagonist tocilizumab in patients with rheumatoid arthritis (RA) affects sleep disturbances. Methods.: Fifteen patients (13 women) with sleep disturbances at baseline received 6 monthly infusions of tocilizumab 8 mg/kg for moderately or severely active RA. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), daytime sleepiness by Epworth Sleepiness Scale, disease activity by the 28-joint Disease Activity Score-erythrocyte sedimentation rate, functional disability by Health Assessment Questionnaire Disability Index (HAQ-DI), and fatigue by the Functional Assessment of Chronic Illness Therapy (FACIT-Fatigue Scale; FFS) at baseline and first, second, third, and sixth month of treatment. Medications used before enrollment remained unchanged during followup. Results.: Sleep quality improved and daytime sleepiness decreased significantly at first-month assessment (p < 0.00001 and p < 0.004, respectively, by repeated measurement analysis) compared to baseline, and these changes became more evident through 6 months. Disease activity decreased, fatigue decreased, and functional status improved significantly. Changes in PSQI score over time were not associated with the corresponding changes in DAS28-ESR (r = 0.37, p = 0.17), but correlated significantly with HAQ-DI changes (r = 0.60, p = 0.02) and marginally with changes in FFS scores (r = −0.46, p = 0.08). Conclusion.: Improvement of sleep quality after tocilizumab treatment in patients with RA does not appear to directly result from decreased disease activity, further suggesting that aberrant IL-6 regulation is associated with sleep disturbances.
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Increases of inflammatory markers accompany the process of aging, a phenomenon termed inflammaging.
“Furthermore, increases of inflammatory markers accompany the process of aging, a phenomenon termed inflammaging (96, 197).”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [197]
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- Authors
- FRAGIADAKI, K., TEKTONIDOU, M. G., KONSTA, M., CHROUSOS, G. P., & SFIKAKIS, P. P.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- SFIKAKIS, PETROS P.
- Venue
- The Journal of Rheumatology
- Publisher
- The Journal of Rheumatology
- Published
- 2011-12-01
- Volume
- 39
- Issue
- 1
- Pages
- 60-62
- ISSN
- 0315-162X (ISSN-L)
- 1499-2752
- OpenAlex
- W2332021218
- Cited by
- 82
- References
- 16
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 6 · 2023: 7 · 2022: 6 · 2021: 4 · 2020: 5 · 2019: 7 · 2018: 4 · 2017: 4 · 2016: 4 · 2015: 11 · 2014: 6 · 2013: 9 · 2012: 3
- FWCI
- 4.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Rheumatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Hematology › Autoimmune and Inflammatory Disorders Research
- Keywords
- rheumatoid arthritis, sleep disorders, tocilizumab, IL-6 receptor inhibition, sleep quality, daytime sleepiness, fatigue, functional disability, disease activity, IL-6 signaling
- MeSH terms
- Adult, Aged, Arthritis, Rheumatoid, Female, Humans, Male, Middle Aged, Pilot Projects, Severity of Illness Index, Sleep Wake Disorders, Interleukin-6, Treatment Outcome, Antirheumatic Agents, Receptors, Interleukin-6, Antibodies, Monoclonal, Humanized
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