natgillin/translations-raw huggingface dataset:
Patienter med symptomer, som kan tyde på kompliceret diverticulitis som f. eks. abdominale smerter, blødning og/ eller uforklarlig ændring af tarmfunktionen med feber, bør undersøges omgående med henblik på tidlig identificering af diverticulitis, som kan være ledsaget af gastrointestinal perforation.
Patients presenting with symptoms potentially indicative of complicated diverticulitis, such as abdominal pain, haemorrhage and/ or unexplained change in bowel habits with fever should be evaluated promptly for early identification of diverticulitis which can be associated with gastrointestinal perforation.
4. 8).
Hypersensitivity reactions Serious hypersensitivity reactions have been reported in association with infusion of RoActemra in approximately 0.3% of patients (see section 4.8).
Der skal være passende behandling til rådighed til øjeblikkelig brug i tilfælde af, at der opstår en anafylaktisk reaktion under administration af RoActemra.
Appropriate treatment should be available for immediate use in the event of an anaphylactic reaction during administration of RoActemra.
4. 8).
4 Active hepatic disease and hepatic impairment Treatment with RoActemra, particularly when administered concomitantly with MTX, may be associated with elevations in hepatic transaminases (see section 4.8).
4. 2).
Therefore, caution should be exercised when considering treatment of patients with active hepatic disease or hepatic impairment, as the safety of RoActemra in these patients has not been adequately studied (see section 4.2).
4. 8).
Hepatic transaminase elevations In clinical trials, transient or intermittent mild and moderate elevations of hepatic transaminases have been reported commonly with RoActemra treatment, without progression to hepatic injury (see section 4.8).
Der blev set en øget hyppighed af disse stigninger, når der blev givet potentielt hepatotoksiske lægemidler (f. eks.
An increased frequency of these elevations was observed when potentially hepatotoxic drugs (e. g.
Der skal udvises forsigtighed, hvis det overvejes at påbegynde behandling med RoActemra hos patienter med forhøjet ALAT eller ASAT dvs. hos patienter, som har værdier, der er > 1, 5 gange øvre referencegrænse.
Caution should be exercised when considering initiation of RoActemra treatment in patients with elevated ALT or AST > 1.5 x ULN.
Behandlingen bør ikke anvendes til patienter med forhøjet ALAT eller ASAT dvs. hos patienter, som har værdier, der er > 5 gange øvre referencegrænse.
In patients with baseline ALT or AST > 5 x ULN, treatment is not recommended.
Se pkt.
ALT and AST levels should be monitored every 4 to 8 weeks for the first 6 months of treatment followed by every 12 weeks thereafter.
4. 2 vedrørende de anbefalede dosisændringer baseret på transaminaser.
For recommended modifications based on transaminases see section 4.2.
Behandlingen med RoActemra bør stoppes, hvis stigningerne i ALAT eller ASAT bekræftes at være > 3 – 5 gange øvre referencegrænse ved en ny prøve.
For ALT or AST elevations > 3– 5 x ULN, confirmed by repeat testing, RoActemra treatment should be interrupted.
Behandlingen med RoActemra kan genoptages med 4 eller 8mg/ kg, når levertransaminaserne er under 3 gange øvre referencegrænse.
Once the patient ’ s hepatic transaminases are below 3 x ULN, treatment with RoActemra may recommence at 4 or 8 mg/ kg.
4. 8).
Haematological abnormalities Decreases in neutrophil and platelet counts have occurred following treatment with tocilizumab 8 mg/ kg in combination with MTX (see section 4.8).
Der kan være øget risiko for neutropeni hos patienter, som tidligere er behandlet med en TNF- antagonist.
There may be an increased risk of neutropenia in patients who have previously been treated with a TNF antagonist.
Der skal udvises forsigtighed, hvis det overvejes af påbegynde behandling med RoActemra hos patienter med et lavt neutrofil - eller trombocyttal (dvs. et neutrofiltal < 2 x 109/ l eller et trombocyttal < 100 x 109/ l).
ANC < 2 x 109/ l or platelet count below 100 x 103/ μ l).
Behandlingen bør ikke anvendes hos patienter med et neutrofiltal < 0, 5 x 109/ l eller et trombocyttal < 50 x 103/ μl.
In patients with an ANC < 0.5 x 109/ l or a platelet count < 50 x 103/ μ l treatment is not recommended.
Neutrofil - og trombocyttallet bør kontrolleres 4 til 8 uger efter behandlingens start og derefter i henhold til god klinisk praksis.
Neutrophils and platelets should be monitored 4 to 8 weeks after start of therapy and thereafter according to standard clinical practice.
4. 2 vedrørende dosisændringer baseret på neutrofiltal og trombocyttal.
For recommended dose modifications based on ANC and platelet counts, see section 4.2.
Lipidparametre Der er set stigninger i lipidparametre så som total cholesterol, LDL- cholesterol, HDL- cholesterol og triglycerider hos de patienter, som blev behandlet med RoActemra (se pkt.
Lipid parameters Elevations in lipid parameters including total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides were observed in patients treated with tocilizumab (see section 4.8).
Hos de fleste patienter steg det atherogene indeks ikke, og stigningerne i total cholesterol responderede på behandling med lipidsænkende midler.
In the majority of patients, there was no increase in atherogenic indices, and elevations in total cholesterol responded to treatment with lipid lowering agents.
Lipidparametrene bør vurderes 4 til 8 uger efter, at behandlingen med RoActemra er påbegyndt.
Assessment of lipid parameters should be performed 4 to 8 weeks following initiation of RoActemra therapy.
Neurologiske hændelser Der bør udvises opmærksomhed på symptomer, som kan tyde på start af nye centrale demyeliserende sygdomme.
Neurological disorders Physicians should be vigilant for symptoms potentially indicative of new-onset central demyelinating disorders.
5 Malignitet Risikoen for malignitet er forhøjet hos patienter med reumatoid artrit.
Malignancy The risk of malignancy is increased in patients with RA.
Vaccinationer Levende og levende, svækkede vacciner bør ikke gives samtidigt med RoActemra, da den kliniske sikkerhed ikke er dokumenteret.
Vaccinations Live and live attenuated vaccines should not be given concurrently with RoActemra as clinical safety has not been established.
Kardiovaskulær risiko Patienter med reumatoid artrit har øget risiko for kardiovaskulære sygdomme, og risikofaktorer (f. eks. hypertension og hyperlipidæmi) skal behandles efter gældende standarder.
5 Cardiovascular risk RA patients have an increased risk for cardiovascular disorders and should have risk factors (e. g. hypertension, hyperlipidaemia) managed as part of usual standard of care.
Kombination med TNF- antagonister Der er ingen erfaring med anvendelse af RoActemra sammen med TNF- antagonister eller andre biologiske behandlinger for reumatoid artrit.
Combination with TNF antagonists There is no experience with the use of RoActemra with TNF antagonists or other biological treatments for RA.
Natrium Dette lægemiddel indeholder 1, 17 mmol (eller 26, 55 mg) natrium pr. maksimumdosis på 1200 mg.
Sodium This medicinal product contains 1.17 mmol (or 26.55 mg) sodium per maximum dose of 1200 mg.
Doser under 1025 mg indeholder mindre end 1 mmol natrium (23 mg), dvs. de er i princippet ” natriumfrie ”.
Doses below 1025 mg of this medicinal product contain less than 1 mmol sodium (23 mg), i. e. essentially ‘ sodium free’.
Samtidig administration af en enkeltdosis tocilizumab på 10 mg/ kg og MTX 10- 25 mg én gang ugentlig havde ingen klinisk signifikant virkning på eksponeringen af MTX.
Concomitant administration of a single dose of 10 mg/ kg tocilizumab with 10-25 mg MTX once weekly had no clinically significant effect on MTX exposure.
Populationsfarmakokinetisk analyse har ikke påvist effekt af MTX, non- steroide antiinflammatoriske midler (NSAIDs) eller kortikosteroider på tocilizumabs clearance.
Population pharmacokinetic analyses did not detect any effect of MTX, non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids on tocilizumab clearance.
Ekspression af hepatiske CYP450- enzymer supprimeres af cytokiner så som IL- 6, som stimulerer kronisk inflammation.
The expression of hepatic CYP450 enzymes is suppressed by the cytokines, such as IL-6, that stimulate chronic inflammation.
Ekspression af CYP450 kan derfor reverteres, hvis der initieres behandling med potente cytokinhæmmere f. eks. tocilizumab.
Thus, CYP450 expression may be reversed when potent cytokine inhibitory therapy, such as tocilizumab, is introduced.
In vitro- studier med dyrkede, humane hepatocytter har vist, at IL- 6 medførte en reduktion i ekspressionen af enzymerne CYP1A2, CYP2C9, CYP2C19 og CYP3A4.
In vitro studies with cultured human hepatocytes demonstrated that IL-6 caused a reduction in CYP1A2, CYP2C9, CYP2C19, and CYP3A4 enzyme expression.
Når behandlingen med tocilizumab påbegyndes eller ophører, skal patienter, der tager lægemidler, som er individuelt justerede, og som metaboliseres via CYP450 3A4, 1A2, 2C9 eller 2C19 (f. eks. atorvastatin, calciumkanalblokkere, theophyllin, warfarin, phenytoin, ciclosporin eller benzodiazepiner) kontrolleres, da dosis måske skal justeres for at bevare den terapeutiske virkning.
When starting or stopping therapy with tocilizumab, patients taking medicinal products which are individually adjusted and are metabolised via CYP450 3A4, 1A2, 2C9 or 2C19 (e. g. atorvastatin, calcium channel blockers, theophylline, warfarin, phenytoin, ciclosporin, or benzodiazepines) should be monitored as doses may need to be increased to maintain therapeutic effect.
På grund af den lange eliminationshalveringstid (t1/ 2) kan virkningen af tocilizumab på enzymaktiviteten af CYP450 persistere i flere uger efter, at behandlingen er stoppet.
Given its long elimination half-life (t1/ 2), the effect of tocilizumab on CYP450 enzyme activity may persist for several weeks after stopping therapy.
Graviditet De foreliggende data for anvendelse af tocilizumab til gravide er utilstrækkelige.
Pregnancy There are no adequate data from the use of tocilizumab in pregnant women.
5. 3).
A study in animals has shown an increased risk of spontaneous abortion/ embryo-foetal death at a high dose (see section 5.3).
Kvinder i den fertile alder skal anvende sikker kontraception under behandlingen og indtil 6 måneder efter behandlingen.
Women of childbearing potential must use effective contraception during and up to 6 months after treatment.
6 Amning Det vides ikke, om tocilizumab udskilles i human modermælk.
Lactation It is unknown whether tocilizumab is excreted in human breast milk.
Beslutningen om, hvorvidt amningen skal fortsætte eller stoppe, eller om behandlingen med RoActemra skal fortsætte eller stoppe, skal tages efter afvejning af barnets fordele ved amningen overfor kvindens fordele ved behandlingen med RoActemra.
A decision on whether to continue/ discontinue breast-feeding or to continue/ discontinue therapy with RoActemra should be made taking into account the benefit of breast-feeding to the child and the benefit of RoActemra therapy to the woman.
Da svimmelhed er almindeligt rapporteret, bør patienter, som oplever denne bivirkning, dog rådgives om ikke at føre motorkøretøj eller betjene maskiner, indtil svimmelheden er ophørt.
However, given that dizziness has been commonly reported, patients who experience this adverse reaction should be advised not to drive or use machines until it has resolved.
I alt 3778 patienter fik mindst én dosis RoActemra på 4 mg/ kg eller 8 mg/ kg.
A total of 3,778 patients received at least one dose of RoActremra 4 mg/ kg or 8 mg/ kg.
5. 1).
The adverse drug reactions (ADRs) presented in Table 1 are based on the safety of tocilizumab studied in 4 placebo-controlled studies (studies II, III, IV and V) and 1 MTX-controlled study (study I) (see section 5.1).
I disse studier fik 774 patienter tocilizumab 4 mg/ kg i kombination med MTX, 1582 patienter fik tocilizumab 8 mg/ kg i kombination med MTX eller andre DMARDs, og 288 patienter fik tocilizumab 8 mg/ kg som monoterapi.
In these studies, 774 patients received tocilizumab 4 mg/ kg in combination with MTX, 1,582 patients received tocilizumab 8 mg/ kg in combination with MTX or other DMARDs and 288 patients received tocilizumab 8 mg/ kg monotherapy.
Det åbne langtidsekstensionsstudie omfattede 2562 patienter, der fik tocilizumab 8 mg/ kg med eller uden DMARDs.
The long-term open label extension studies included 2,562 patients who received tocilizumab 8 mg/ kg with or without DMARDs.
Den samlede eksponeringstid i langtidssikkerhedsanalysen var 3685 patientår.
The total exposure in the long-term safety analysis was 3,685 patient years.
De mest almindeligt indberettede bivirkninger (som forekom hos ≥ 5% af patienterne, der fik tocilizumab- monoterapi eller kombinationsbehandling med DMARDs) var øvre luftvejsinfektioner, nasopharyngitis, hovedpine, hypertension og øget ALAT.
The most commonly reported ADRs (occurring in ≥ 5% of patients treated with tocilizumab monotherapy or in combination with DMARDs) were upper respiratory tract infections, nasopharyngitis, headache, hypertension and increased ALT.
Meget almindelig (≥ 1/ 10), almindelig (≥ 1/ 100 til < 1/ 10) eller ikke almindelig (≥ 1/ 1000 til < 1/ 100).
The ADRs listed in Table 1 are presented by system organ class and frequency categories, defined using the following convention: very common (≥ 1/ 10); common (≥ 1/ 100 to < 1/ 10) or uncommon (≥ 1/ 1,000 to < 1/ 100).
Sammenfatning af de bivirkninger, som forekom hos patienter med reumatoid artrit, der fik behandling med tocilizumab som monoterapi eller i kombination med MTX eller andre DMARDs
Summary of ADRs occurring in patients with RA receiving tocilizumab as monotherapy or in combination with MTX or other DMARDs
Diverticulitis
Diverticulitis
Mave- tarmkanalen Hud og subkutane væv Nervesystemet
Mouth ulceration, Gastritis
Sår i munden, gastritis Udslæt, pruritus Hovedpine, svimmelhed
Skin and subcutaneous tissue disorders
Stomatitis Urticaria
Urticaria
Forhøjede levertransaminaser
Hepatic transaminases increased
Øget total bilirubin
Total bilirubin increased
Vaskulære sygdomme Blod og lymfesystem
Vascular disorders
Hypertension Leukopeni, neutropeni
Hypertension
Metabolisme og ernæring
Leukopenia, Neutropenia
Hypercholesterolæmi
Hypercholesterolaemia
Hypersensitivitets - reaktioner
Hypersensitivity reactions
Conjunctivitis
Conjunctivitis
100 patientår i gruppen med placebo plus DMARD.
7 Infections In the controlled studies the rate of all infections reported with tocilizumab 8 mg/ kg plus DMARD treatment was 127 events per 100 patient years compared to 112 events per 100 patient years in the placebo plus DMARD group.
100 patientårseksponering.
In the long-term open label extension studies, the rate of infections with RoActemra plus DMARDs was 116 events per 100 patient years exposure.
I kontrollerede kliniske studier var hyppigheden af alvorlige infektioner efter tocilizumab 8 mg/ kg plus DMARDs 5, 3 hændelser pr.
In controlled clinical studies, the rate of serious infections with tocilizumab 8 mg/ kg plus DMARDs was 5.3 events per 100 patient years exposure compared to 3.9 events per 100 patient years exposure in the placebo plus DMARD group.
I monoterapi- studiet var hyppigheden af alvorlige infektioner 3, 6 hændelser pr.
In the monotherapy study the rate of serious infections was 3.6 events per 100 patient years of exposure in the tocilizumab group and 1.5 events per 100 patient years of exposure in the MTX group.
100 patientårseksponering.
In the long-term safety population (core and extension studies), the rate of serious infections observed with tocilizumab plus DMARD treatment was 3.9 events per 100 patient years exposure.
De indberettede alvorlige infektioner omfattede pneumoni, cellulitis, herpes zoster, gastroenteritis, diverticulitis, sepsis og bakteriel arthritis.
Reported serious infections included pneumonia, cellulitis, herpes zoster, gastroenteritis, diverticulitis, sepsis and bacterial arthritis.
Alvorlige infektioner var sjældent fatale.
Serious infections were rarely fatal.
Komplikationer til diverticulitis Under de kontrollerede 6- måneders- studier har der i sjældne tilfælde været indberetninger om komplikationer til diverticulitis, herunder generaliseret purulent peritonitis, nedre gastrointestinal perforation, fistler og absces efter behandling med tocilizumab.
Complications of diverticulitis During the six month controlled trials, complications of diverticulitis including generalised purulent peritonitis, lower gastrointestinal perforation, fistulae and abscess have been reported uncommonly with tocilizumab therapy.
Infusionsreaktioner Der blev indberettet uønskede hændelser i forbindelse med infusion (udvalgte hændelser, som indtraf under eller inden for 24 timer efter infusionen) hos 6, 9% af patienterne, der fik tocilizumab 8 mg/ kg plus DMARD, og hos 5, 1% af patienterne, der fik placebo plus DMARD.
Infusion reactions Adverse events associated with infusion (selected events occurring during or within 24 hours of infusion) were reported by 6.9% of patients in the tocilizumab 8 mg/ kg plus DMARD group and 5.1% of patients in the placebo plus DMARD group.
Hyppigheden af anafylaktiske reaktioner (som forekom hos i alt 6/ 3778 patienter; 0, 2%) var flere gange højere efter en dosis på 4 mg/ kg sammenlignet med en dosis på 8 mg/ kg.
The rate of anaphylactic reactions (occurring in a total of 6/ 3,778 patients, 0.2%) was several fold higher with the 4 mg/ kg dose, compared to the 8 mg/ kg dose.
I de kontrollerede og åbne kliniske studier blev der i forbindelse med tocilizumab indberettet klinisk signifikante hypersensitivitetsreaktioner, som krævede afbrydelse af behandlingen, hos 13 ud af 3778 patienter (0, 3%).
Clinically significant hypersensitivity reactions associated with tocilizumab and requiring treatment discontinuation were reported in a total of 13 out of 3,778 patients (0.3%) treated with tocilizumab during the controlled and open label clinical studies.
4. 4).
These reactions were generally observed during the second to fifth infusions of tocilizumab (see section 4.4).
Immunogenicitet I alt 2876 patienter er blevet testet for antitocilizumabantistoffer i de kontrollerede kliniske studier.
Immunogenicity A total of 2,876 patients have been tested for anti-tocilizumab antibodies in the controlled clinical trials.
Af de 46 patienter (1, 6%), som udviklede antitocilizumabantistoffer, havde 6 en ledsagende, medicinsk signifikant hypersensitivitetsreaktion, som hos 5 medførte permanent seponering af behandlingen.
Of the 46 patients (1.6%) who developed anti-tocilizumab antibodies, 6 had an associated medically significant hypersensitivity reaction, of which 5 led to permanent discontinuation of treatment.
Der blev ikke set nogen klar korrelation til det kliniske respons hos 30 patienter (1, 1%), som udviklede neutraliserende antistoffer.
In 30 patients (1.1%) who developed neutralising antibodies, no apparent correlation to clinical response was observed.
Hæmatologiske anormaliteter Der forekom fald i neutrofiltal til under 1 x 109/ l hos 3, 4% af de patienter, som fik tocilizumab 8 mg/ kg plus DMARDs, sammenlignet med < 0, 1% af de patienter, som fik placebo plus DMARDs.
Haematological abnormalities Decreases in neutrophil counts below 1 x 109/ l occurred in 3.4% of patients on tocilizumab 8 mg/ kg plus DMARDs compared to < 0.1% of patients on placebo plus DMARDs.
Ca. halvdelen af de patienter, som udviklede neutrofiltal < 1 x 109/ l, fik det indenfor 8 uger efter behandlingens start.
Approximately half of the patients who developed an ANC < 1 x 109/ l did so within 8 weeks after starting therapy.
Der blev indberettet om fald til under 0, 5 x 109/ l hos 0, 3% af de patienter, som fik tocilizumab 8 mg/ kg plus DMARDs.
Decreases below 0.5 x 109/ l were reported in 0.3% patients receiving tocilizumab 8 mg/ kg plus DMARDs.
Der var ingen klar forbindelse mellem faldet i neutrofile celler og forekomsten af alvorlige infektioner.
There was no clear association between decreases in neutrophils and the occurrence of serious infections.
Der blev set fald i trombocyttallene til under 100 x 109/ l hos 1, 7% af de patienter, der fik tocilizumab 8 mg/ kg plus DMARDs, sammenlignet med < 1% hos de patienter, der fik placebo plus DMARDs.
Decreases in platelet counts below 100 x 103/ μ l occurred in 1.7% of patients on tocilizumab 8 mg/ kg plus DMARDs compared to < 1% on placebo plus DMARDs.
Faldene forekom uden hændelser med ledsagende blødninger.
These decreases occurred without associated bleeding events.
8 Forhøjede levertransaminaser Der blev set forbigående stigninger af ALAT/ ASAT til > 3 gange øvre referencegrænse hos 2, 1% af de patienter, der fik tocilizumab 8 mg/ kg, sammenlignet med 4, 9% af de patienter, der fik MTX og hos 6, 5% af de patienter, der fik 8 mg/ kg tocilizumab plus DMARDs, sammenlignet med 1, 5% af de patienter, der fik placebo plus DMARDs.
8 Hepatic transaminase elevations Transient elevations in ALT/ AST > 3 x ULN were observed in 2.1% of patients on tocilizumab 8 mg/ kg compared to 4.9% of patients on MTX and in 6.5% of patients who received 8 mg/ kg tocilizumab plus DMARDs compared to 1.5% of patients on placebo plus DMARDs.
Tillæg af potentielt hepatotoksiske lægemidler (f. eks.
The addition of potentially hepatotoxic drugs (e. g.
Der blev set stigninger af ALAT/ ASAT til > 5 gange øvre referencegrænse hos 0, 7% af de patienter, der fik på tocilizumab monoterapi, og hos 1, 4% af de patienter, der fik tocilizumab plus DMARD.
Elevations of ALT/ AST > 5 x ULN were observed in 0.7% of tocilizumab monotherapy patients and 1.4% of tocilizumab plus DMARD patients, the majority of whom were discontinued permanently from tocilizumab treatment.
Lipidparametre Under de 6- måneders kontrollerede studier blev der hyppigt indberettet stigninger i lipidparametrene, såsom total cholesterol, triglycerider, LDL- cholesterol og/ eller HDL- cholesterol.
Lipid parameters During the six month controlled trials, increases of lipid parameters such as total cholesterol, triglycerides, LDL cholesterol, and/ or HDL cholesterol have been reported commonly.
24% af de patienter, som fik RoActemra i de kliniske studier, fik vedvarende stigninger i total cholesterol til ≥ 6, 2 mmol/ l, heraf fik 15% vedvarende stigning i LDL til ≥ 4, 1 mmol/ l.
Approximately 24% of patients receiving RoActemra in clinical trials experienced sustained elevations in total cholesterol ≥ 6.2 mmol/ l, with 15% experiencing a sustained increase in LDL to ≥ 4.1 mmol/ l.
Malignitet De kliniske data er ikke tilstrækkelige til at vurdere den mulige incidens af malignitet efter eksponering af tocilizumab.
Malignancies The clinical data are insufficient to assess the potential incidence of malignancy following exposure to tocilizumab.
Der blev indberettet et tilfælde af utilsigtet overdosering, hvor en patient med multipelt myelom fik en enkeltdosis på 40 mg/ kg.
One case of accidental overdose was reported in which a patient with multiple myeloma received a single dose of 40 mg/ kg.
Der er ikke observeret alvorlige bivirkninger hos raske frivillige, som fik en enkeltdosis på op til 28 mg/ kg, selvom der blev set dosisbegrænsende neutropeni.
No serious adverse reactions were observed in healthy volunteers who received a single dose up to 28 mg/ kg, although dose limiting neutropenia was observed.
Immunsupprimerende midler, interleukinhæmmere, ATC- kode:
Immunosupressants, Interleukin inhibitors; ATC code:
Virkningsmekanisme Tocilizumab bindes specifikt til både opløselige og membranbundne IL- 6 receptorer (sIL- 6R og mIL - 6R).
Mechanism of action Tocilizumab binds specifically to both soluble and membrane-bound IL-6 receptors (sIL-6R and mIL-6R).
Det er vist, at tocilizumab hæmmer sIL- 6R og mIL- 6R- medieret signalering.
Tocilizumab has been shown to inhibit sIL-6R and mIL-6R-mediated signalling.
IL- 6 er et pleiotropisk pro- inflammatorisk cytokin, som dannes af forskellige celletyper, herunder T - og B- celler, monocytter og fibroblaster.
IL-6 is a pleiotropic pro-inflammatory cytokine produced by a variety of cell types including T- and B-cells, monocytes and fibroblasts.