There is currently a global shortage of tocilizumab (Actemra®). As a result tocilizumab products are currently in limited supply in Australia. If you are currently taking tocilizumab (Actemra®), these shortages may affect your treatment.
The supply of all tocilizumab products is expected to remain limited until at least the first half of 2022.
Arthritis Australia continues to work with the Therapeutic Goods Administration (TGA), Roche Australia, and the Australian Rheumatology Association (ARA) to manage the shortage and communicate to consumers.
IV tocilizumab consumers
Supply is improving and hospitals are receiving increased allocations of IV tocilizumab, however these will still be less than pre-pandemic levels.
Due to the improved outlook, some further changes have been made to the recommendations for use for those consumers who are currently or previously on IV tocilizumab.
The new ARA recommendations are as follows:
Systemic juvenile idiopathic arthritis (sJIA) consumers and polyarticular juvenile idiopathic arthritis (pJIA) consumers
- Consumers undergoing IV tocilizumab treatment for sJIA and pJIA may resume their normal dosing regimen.
- Consumers with sJIA and pJIA can be initiated on IV tocilizumab if required.
Adult rheumatoid arthritis consumers
- Adult consumers who have been continued on IV tocilizumab treatment for rheumatoid arthritis during the shortage may resume their normal dosing regimen if dosing intervals have been increased during the shortage.
- For those adult consumers who were previously on IV tocilizumab and were switched to alternative biologic or targeted synthetic agent due to the tocilizumab shortage but are now experiencing flare may resume IV tocilizumab.
- Adult consumers who were switched from IV tocilizumab to abatacept can be switched back to IV tocilizumab.
- Consider initiation of IV tocilizumab in adult RA consumers if clinically indicated.
Consumers should contact their rheumatologists for further advice.
Subcutaneous (SC) tocilizumab consumers
Supply of subcutaneous tocilizumab is improving. Due to the improved supply, the ARA now recommend that:
- Adult consumers who were switched from SC tocilizumab to abatacept can be switched back to SC tocilizumab
Consumers should contact their rheumatologists for further advice. To assist consumers, the tocilizumab Serious Scarcity Substitution Instrument (SSSI) has been extended until 30 April 2022. The SSSI makes sure that pharmacists can offer adult consumers whichever subcutaneous presentation is available at the pharmacy without the need for a new script.