{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T08:32:54Z","timestamp":1781685174297,"version":"3.54.5"},"reference-count":36,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2017,6,24]],"date-time":"2017-06-24T00:00:00Z","timestamp":1498262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Microbiology, Immunology and Infection"],"published-print":{"date-parts":[[2019,2]]},"DOI":"10.1016\/j.jmii.2017.04.002","type":"journal-article","created":{"date-parts":[[2017,6,30]],"date-time":"2017-06-30T23:15:53Z","timestamp":1498864553000},"page":"141-150","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":29,"title":["Safety and effectiveness of tocilizumab in treating patients with rheumatoid arthritis \u2013 A three-year study in Taiwan"],"prefix":"10.1016","volume":"52","author":[{"given":"Ching-Tsai","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Nan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Wei","family":"Hsieh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Ming","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Der-Yuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsu-Yi","family":"Hsieh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8135-9554","authenticated-orcid":false,"given":"Yi-Hsing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jmii.2017.04.002_bib1","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/S0140-6736(08)60453-5","article-title":"Effect of interleukin-6 receptor inhibition with tocilizumab in patients with rheumatoid arthritis (OPTION study): a double-blind, placebo-controlled, randomised trial","volume":"371","author":"Smolen","year":"2008","journal-title":"Lancet"},{"key":"10.1016\/j.jmii.2017.04.002_bib2","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1002\/art.30158","volume":"63","author":"Kremer","year":"2011","journal-title":"Arthritis Rheum"},{"key":"10.1016\/j.jmii.2017.04.002_bib3","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1136\/annrheumdis-2013-204573","article-title":"EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update","volume":"73","author":"Smolen","year":"2014","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.jmii.2017.04.002_bib4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/art.39480","article-title":"2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis","volume":"68","author":"Singh","year":"2016","journal-title":"Arthritis Rheumatol"},{"key":"10.1016\/j.jmii.2017.04.002_bib5","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3899\/jrheum.130466","article-title":"Effectiveness and safety of tocilizumab: postmarketing surveillance of 7901 patients with rheumatoid arthritis in Japan","volume":"41","author":"Koike","year":"2014","journal-title":"J Rheumatol"},{"key":"10.1016\/j.jmii.2017.04.002_bib6","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.jbspin.2010.12.004","article-title":"Incidence of tuberculosis in patients with rheumatoid arthritis. A systematic literature review","volume":"78","author":"Baronnet","year":"2011","journal-title":"Jt Bone Spine"},{"key":"10.1016\/j.jmii.2017.04.002_bib7","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.5588\/ijtld.13.0368","article-title":"Risk of tuberculosis in rheumatoid arthritis patients on tumour necrosis factor-alpha inhibitor treatment in Taiwan","volume":"17","author":"Ke","year":"2013","journal-title":"Int J Tuberc Lung Dis"},{"issue":"Suppl. 3","key":"10.1016\/j.jmii.2017.04.002_bib8","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/1756-185X.12539","article-title":"Risk of tuberculosis, serious infection and lymphoma with disease-modifying biologic drugs in rheumatoid arthritis patients in Taiwan","volume":"17","author":"Chiu","year":"2014","journal-title":"Int J Rheum Dis"},{"key":"10.1016\/j.jmii.2017.04.002_bib9","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1002\/art.11137","article-title":"Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: a multicenter active-surveillance report","volume":"48","author":"Gomez-Reino","year":"2003","journal-title":"Arthritis Rheumatol"},{"key":"10.1016\/j.jmii.2017.04.002_bib10","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1056\/NEJM199712113372406","article-title":"Hepatitis B virus infection","volume":"337","author":"Lee","year":"1997","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jmii.2017.04.002_bib11","series-title":"Global Tuberculosis Report 2015","author":"Organization WH","year":"2015"},{"key":"10.1016\/j.jmii.2017.04.002_bib12","first-page":"1","article-title":"Epidemiological study on hepatitis B virus infection in Taiwan","volume":"6","author":"Sung","year":"1984","journal-title":"Clin J Gastroenterol"},{"key":"10.1016\/j.jmii.2017.04.002_bib13","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1002\/jmv.1890260408","article-title":"Seroepidemiological studies on hepatitis B and D viruses infection among five ethnic groups in southern Taiwan","volume":"26","author":"Chung","year":"1988","journal-title":"J Med Virol"},{"key":"10.1016\/j.jmii.2017.04.002_bib14","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1136\/ard.2010.148783","article-title":"Kinetics of viral loads and risk of hepatitis B virus reactivation in hepatitis B core antibody-positive rheumatoid arthritis patients undergoing anti-tumour necrosis factor alpha therapy","volume":"70","author":"Lan","year":"2011","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.jmii.2017.04.002_bib15","unstructured":"Notifiable Infectious Diseases Statistics System. [http:\/\/nidss.cdc.gov.tw\/ch\/SingleDisease.aspx?dc=1&dt=3&disease=0703]."},{"key":"10.1016\/j.jmii.2017.04.002_bib16","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/art.1780310302","article-title":"The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis","volume":"31","author":"Arnett","year":"1988","journal-title":"Arthritis Rheum"},{"key":"10.1016\/j.jmii.2017.04.002_bib17","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"2010 rheumatoid arthritis classification criteria: an American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum"},{"key":"10.1016\/j.jmii.2017.04.002_bib18","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1136\/ard.2007.084459","volume":"68","author":"Wells","year":"2009","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.jmii.2017.04.002_bib19","first-page":"1","article-title":"Screening and management of hepatitis B infection in rheumatic patients scheduled for biologic therapy: consensus recommendations from the Taiwan Rheumatology Association","volume":"26","author":"Chen","year":"2012","journal-title":"Formos J Rheumatol"},{"key":"10.1016\/j.jmii.2017.04.002_bib20","first-page":"8","article-title":"Screening and management of tuberculosis infection in patients scheduled for tumor necrosis factor -alpha inhibitors: consensus recommendations from the Taiwan Rheumatology Association","volume":"26","author":"Chen","year":"2012","journal-title":"Formos J Rheumatol"},{"key":"10.1016\/j.jmii.2017.04.002_bib21","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1136\/ard.2008.092932","article-title":"IL-6 receptor inhibition with tocilizumab improves treatment outcomes in patients with rheumatoid arthritis refractory to anti-tumour necrosis factor biologicals: results from a 24-week multicentre randomised placebo-controlled trial","volume":"67","author":"Emery","year":"2008","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.jmii.2017.04.002_bib22","doi-asserted-by":"crossref","first-page":"1806","DOI":"10.1136\/annrheumdis-2015-207872","article-title":"Comparison of lipid and lipid-associated cardiovascular risk marker changes after treatment with tocilizumab or adalimumab in patients with rheumatoid arthritis","volume":"75","author":"Gabay","year":"2016","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.jmii.2017.04.002_bib23","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1136\/ard.2008.092866","article-title":"Long-term safety and efficacy of tocilizumab, an anti-IL-6 receptor monoclonal antibody, in monotherapy, in patients with rheumatoid arthritis (the STREAM study): evidence of safety and efficacy in a 5-year extension study","volume":"68","author":"Nishimoto","year":"2009","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.jmii.2017.04.002_bib24","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s13075-015-0559-8","article-title":"Significant effects of biologic therapy on lipid profiles and insulin resistance in patients with rheumatoid arthritis","volume":"17","author":"Chen","year":"2015","journal-title":"Arthritis Res Ther"},{"key":"10.1016\/j.jmii.2017.04.002_bib25","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1136\/ard.2010.135871","article-title":"Lipid paradox in rheumatoid arthritis: the impact of serum lipid measures and systemic inflammation on the risk of cardiovascular disease","volume":"70","author":"Myasoedova","year":"2011","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.jmii.2017.04.002_bib26","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1136\/annrheumdis-2013-204933","article-title":"Inflammation and lipid profile in rheumatoid arthritis: bridging an apparent paradox","volume":"73","author":"Gonzalez-Gay","year":"2014","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.jmii.2017.04.002_bib27","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1002\/art.38974","article-title":"Potential mechanisms leading to the abnormal lipid profile in patients with rheumatoid arthritis versus healthy volunteers and reversal by tofacitinib","volume":"67","author":"Charles-Schoeman","year":"2015","journal-title":"Arthritis Rheumatol"},{"key":"10.1016\/j.jmii.2017.04.002_bib28","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1093\/rheumatology\/keq343","article-title":"Risk of adverse events including serious infections in rheumatoid arthritis patients treated with tocilizumab: a systematic literature review and meta-analysis of randomized controlled trials","volume":"50","author":"Campbell","year":"2011","journal-title":"Rheumatol (Oxford)"},{"key":"10.1016\/j.jmii.2017.04.002_bib29","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.3899\/jrheum.141210","article-title":"Longterm safety of tocilizumab: results from 3 years of followup postmarketing surveillance of 5573 patients with rheumatoid arthritis in Japan","volume":"42","author":"Yamamoto","year":"2015","journal-title":"J Rheumatol"},{"key":"10.1016\/j.jmii.2017.04.002_bib30","doi-asserted-by":"crossref","first-page":"5747","DOI":"10.1128\/IAI.67.11.5747-5754.1999","article-title":"Interleukin-6 and interleukin-12 participate in induction of a type 1 protective T-cell response during vaccination with a tuberculosis subunit vaccine","volume":"67","author":"Leal","year":"1999","journal-title":"Infect Immun"},{"key":"10.1016\/j.jmii.2017.04.002_bib31","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1084\/jem.188.10.1895","article-title":"Interleukin 6 influences germinal center development and antibody production via a contribution of C3 complement component","volume":"188","author":"Kopf","year":"1998","journal-title":"J Exp Med"},{"key":"10.1016\/j.jmii.2017.04.002_bib32","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1084\/jem.165.3.641","article-title":"Interleukin-HP1, a T cell-derived hybridoma growth factor that supports the in\u00a0vitro growth of murine plasmacytomas","volume":"165","author":"Van Snick","year":"1987","journal-title":"J Exp Med"},{"key":"10.1016\/j.jmii.2017.04.002_bib33","doi-asserted-by":"crossref","first-page":"3322","DOI":"10.1128\/IAI.68.6.3322-3326.2000","article-title":"Interleukin-6 induces early gamma interferon production in the infected lung but is not required for generation of specific immunity to Mycobacterium tuberculosis infection","volume":"68","author":"Saunders","year":"2000","journal-title":"Infect Immun"},{"key":"10.1016\/j.jmii.2017.04.002_bib34","doi-asserted-by":"crossref","first-page":"130","DOI":"10.3109\/s10165-009-0243-4","article-title":"Minimal influence of tocilizumab on IFN-gamma synthesis by tuberculosis antigens","volume":"20","author":"Ogata","year":"2010","journal-title":"Mod Rheumatol"},{"key":"10.1016\/j.jmii.2017.04.002_bib35","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.jbspin.2014.04.004","article-title":"Tocilizumab-associated cutaneous reactive endotheliomatosis in a patient with rheumatoid arthritis","volume":"82","author":"Wu","year":"2015","journal-title":"Jt Bone Spine"},{"key":"10.1016\/j.jmii.2017.04.002_bib36","first-page":"122","article-title":"Incidence of malignancies in Japanese rheumatoid arthritis patients treated with tocilizumab in comparison to those in an observational cohort of Japanese patients and a Japanese population database [abstract]","volume":"66","author":"Yamanaka","year":"2007","journal-title":"Ann Rheum Dis"}],"container-title":["Journal of Microbiology, Immunology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1684118217301056?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1684118217301056?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T13:23:05Z","timestamp":1761657785000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1684118217301056"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["S1684118217301056"],"URL":"https:\/\/doi.org\/10.1016\/j.jmii.2017.04.002","relation":{},"ISSN":["1684-1182"],"issn-type":[{"value":"1684-1182","type":"print"}],"subject":[],"published":{"date-parts":[[2019,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Safety and effectiveness of tocilizumab in treating patients with rheumatoid arthritis \u2013 A three-year study in Taiwan","name":"articletitle","label":"Article Title"},{"value":"Journal of Microbiology, Immunology and Infection","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jmii.2017.04.002","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2017 Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC.","name":"copyright","label":"Copyright"}]}}