Tocilizumab, brand-named Actemra, is a new biologic drug for treating moderate to severe rheumatoid arthtritis that is not well controlled by other medications. It has been approved by the U.S. Food and Drug Administration and should be available for patients during the week of January 18. It is the first drug that blocks a protein called interleukin-6 (IL-6) which is overproduced in the joints of rheumatoid arthritis sufferers. The drug is given once a month by intravenous infusion and is powerful and fast acting. However, there are safety concerns so it must be used cautiously. Side effects experienced by people taking it during clinical trials included elevated LDL or bad cholesterol, high blood pressure, elevated liver enzymes and gastrointestinal perforations. Thus, its use is recommended only for those who have not responded to other therapies and the FDA is requiring the manufacturer to monitor it’s long term safety. Specifically the FDA is interested in evaluating the long term effect of elevated LDL, cholesterol and blood pressure on the cardiovascular health of those on the drug. If this drug is recommended, make sure you have frequent testing by your primary health care provider.