Document Detail


Tocilizumab in refractory adult Still's disease.
MedLine Citation:
PMID:  20740616     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: There is an unmet need for the treatment of adult Still's disease (ASD), the pathogenesis of which may involve interleukin-6 (IL-6). We report the first series of patients with ASD treated with tocilizumab (TCZ), a humanized anti-IL-6 receptor antibody.
METHODS: All ASD patients treated with TCZ in France between July 2006 and July 2009 after failure to all available therapies were included in this cohort study. The main outcome measures were the European League Against Rheumatism (EULAR) improvement criteria and resolution of systemic symptoms at the 3- and 6-month followup periods.
RESULTS: Fourteen patients with refractory ASD were included. At the start of TCZ treatment, despite a mean prednisone dosage of 23.3 mg/day, based on a 28-joint count, mean tender joints were 10.5, mean swollen joints were 7.9, and the mean Disease Activity Score in 28 joints was 5.61. Recurrent systemic involvement, including fever and rash, was present in 7 patients. TCZ was administered at 5-8 mg/kg every 2 or 4 weeks (8 mg/kg/month, n = 9). Eleven patients successfully completed the 6-month study; 1 withdrew due to necrotizing angiodermatitis, another due to chest pain at each TCZ infusion, and a third due to systemic flare. A good EULAR response was observed in 64% of patients (9 of 14) at 3 months and EULAR remission was observed in 57% (8 of 14) at 6 months. Systemic symptoms were resolved in 86% of patients (6 of 7). Moreover, corticosteroid dose was reduced by 56%. No other severe adverse effects occurred.
CONCLUSION: TCZ is a promising new treatment for ASD.
Authors:
Xavier Puéchal; Michel DeBandt; Jean-Marie Berthelot; Maxime Breban; Jean-Jacques Dubost; Olivier Fain; Jean-Emmanuel Kahn; Laurence Lequen; Maïté Longy-Boursier; Aleth Perdriger; Thierry Schaeverbeke; Eric Toussirot; Jean Sibilia;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arthritis care & research     Volume:  63     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  155-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 by the American College of Rheumatology.
Affiliation:
Le Mans General Hospital, Le Mans, France. xpuechal@ch-lemans.fr
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