Tocilizumab (RoActemra(®); Actemra(®)) is a recombinant humanized monoclonal 
antibody that acts as an interleukin-6 receptor antagonist. Both in the US and 
EU, tocilizumab has been approved for the treatment of two subtypes of juvenile 
idiopathic arthritis (JIA), namely systemic JIA (sJIA) and polyarticular JIA 
(pJIA), in patients aged ≥2 years. These approvals are based on favorable 
results from two randomized, double-blind, placebo-controlled, multinational, 
phase III trials in which patients aged 2-17 years with active sJIA (TENDER) or 
pJIA (CHERISH) received an intravenous dose of tocilizumab based on bodyweight 
every 2 or 4 weeks, respectively. Tocilizumab met the primary endpoint in both 
of these ongoing, multi-part studies. That is, in TENDER, significantly more 
tocilizumab recipients than placebo recipients achieved a JIA American College 
of Rheumatology (ACR) 30 response plus absence of fever, as assessed at the end 
of a 12-week double-blind treatment period, while in CHERISH, significantly 
fewer tocilizumab recipients than placebo recipients experienced a JIA ACR 30 
flare during a 24-week double-blind withdrawal period (all patients had 
previously received open-label tocilizumab in a 16-week lead-in phase). 
Tocilizumab was generally well tolerated in the TENDER trial. Infections (e.g. 
upper respiratory tract infection and pharyngitis or nasopharyngitis) accounted 
for just over one-third of all reported adverse events in this trial; 
tocilizumab-treated patients appeared to have an approximately 11 % risk of a 
serious infection per year of treatment. Clinical laboratory abnormalities 
included neutropenia and elevated aminotransferase levels. The tolerability 
profile of tocilizumab in CHERISH was generally consistent with that of the drug 
in TENDER.