The safety of IL-6 inhibitors is unknown in patients who are significantly immunosuppressed; the NIH guidelines recommend against use in this populationSerious infections (fungal, bacterial, TB, viral, opportunistic) have occurred in patients receiving long courses of IL-6 inhibitorsConsider ivermectin in patients who are receiving tocilizumab and corticosteroid in areas where strongyloidiasis is endemicDrug labeling recommends to avoid in ANC <2000/mm3, plt <100,000/mm3, and AST or ALT >1.5 times ULN. The gene discussed is GPT; the disease is infection.