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Antiarrhythmic Potential of Anticytokine Therapy in Rheumatoid Arthritis: Tocilizumab Reduces Corrected QT Interval by Controlling Systemic Inflammation

Patients with rheumatoid arthritis (RA) are twice as likely to experience sudden cardiac death compared with individuals without RA. Although the underlying mechanisms of this have not been clarified, evidence points to the effects of systemic inflammation on ventricular repolarization. Accordingly, prolongation of the corrected QT (QTc) interval is more frequent in patients with RA compared with individuals without RA also correlating with C‐reactive protein (CRP) and predicting all‐cause mortality. Tocilizumab (TCZ) is an anti–interleukin‐6 receptor antibody that potently inhibits inflammatory activation in RA, with rapid normalization of acute‐phase reactant levels, including the CRP level. Therefore, we hypothesized that TCZ may normalize the QTc interval by dampening systemic inflammation, thus reducing the risk of arrhythmia in patients with RA.