Abstract | OBJECTIVE: METHODS: Israeli rheumatologists who treated AOSD with TCZ filled in questionnaires on symptoms, number of tender and swollen joints, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and dosage of prednisone at initial TCZ administration, after 6 months, and at the end of followup. RESULTS: Nine male and 6 female patients, aged 33 ± 12 years, mean disease duration 9 years (range: 1-25) were identified. They had used a mean of 3.6 disease-modifying drugs, including 10 patients with tumor necrosis factor blockers. Intravenous TCZ 8 mg/kg was administered every 4 weeks (12 patients) or every 2 weeks (3 patients). All patients completed at least 6 months of treatment. The mean followup period was 15.7 ± 9 months. At the onset of therapy, despite the use of prednisone (27.6 ± 26.3 mg/d), all patients reported joint pain. Fever was reported in 9 patients, rash in 7, pleuritis in 3, and hepatitis in 2 before TCZ use, with mean ESR and CRP levels of 60 ± 28 mm/h and 11.6 ± 15 mg/dl, respectively. After 6 months of treatment and at the end of followup, the number of tender and swollen joints, the ESR and CRP levels, and the prednisone dosage decreased significantly. Only 2 patients still complained of mild arthralgias, and none reported systemic symptoms at the end of followup. CONCLUSION: TCZ 8 mg/kg was extremely efficacious in treating adult patients with refractory Still's disease. Both TCZ and interleukin 1 blockade should be considered in the treatment algorithm of AOSD. Randomized controlled studies are needed to validate these findings.
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Authors | Ori Elkayam, Nizar Jiries, Zvi Dranitzki, Shay Kivity, Merav Lidar, Ofer Levy, Jacob Ablin, Mahmoud Abu-Shakra, Hagit Savargyl-Maman, Hagit Padova, Dan Caspi, Itzhak Rosner |
Journal | The Journal of rheumatology
(J Rheumatol)
Vol. 41
Issue 2
Pg. 244-7
(Feb 2014)
ISSN: 0315-162X [Print] Canada |
PMID | 24429168
(Publication Type: Journal Article)
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Chemical References |
- Antibodies, Monoclonal, Humanized
- Antirheumatic Agents
- tocilizumab
- Prednisone
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Topics |
- Adult
- Antibodies, Monoclonal, Humanized
(therapeutic use)
- Antirheumatic Agents
(therapeutic use)
- Female
- Humans
- Israel
- Male
- Middle Aged
- Prednisone
(therapeutic use)
- Still's Disease, Adult-Onset
(drug therapy)
- Treatment Outcome
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