Case report: successful use of short-term add-on tocilizumab for multirefractory systemic flare of adult-onset Still's disease.

Abstract

We report on a 64-year-old woman with multirefractory flare of adult-onset Still's disease successfully treated with six-month course of add-on anti-interleukin 6 receptor antibody, tocilizumab. Before administration of tocilizumab, the combination therapy with 80 mg/day of prednisolone and cyclosporine or tacrolimus for five weeks, two courses of pulse methylprednisolone, and high-dose intravenous immunoglobulin could not control the disease. Add-on tocilizumab dramatically improved her disease state and enabled tapering of corticosteroid and tacrolimus. Furthermore remission has been maintained on low-dose corticosteroid and tacrolimus after withdrawal of tocilizumab. This case report suggests that short-term add-on tocilizumab might be a useful therapeutic option for patients with multirefractory flare of polycyclic systemic adult-onset Still's disease.

• Authors: Taio Naniwa, Rei Ito, Maiko Watanabe, Yoshihito Hayami, Shinji Maeda, Kaneshige Sasaki, Shiho Iwagaitsu
• Journal: Clinical rheumatology (Clin Rheumatol) Vol. 32 Suppl 1 Pg. S103-6 (Mar 2013) ISSN: 1434-9949 [Electronic] Germany
• PMID: 20842515 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Monoclonal, Humanized
• Immunoglobulins, Intravenous
• Immunologic Factors
• Cyclosporine
• Prednisolone
• tocilizumab
• Tacrolimus
• Methylprednisolone

Topics

• Antibodies, Monoclonal, Humanized (therapeutic use)
• Cyclosporine (therapeutic use)
• Dose-Response Relationship, Drug
• Drug Resistance, Multiple (drug effects)
• Drug Therapy, Combination
• Female
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Immunologic Factors (therapeutic use)
• Methylprednisolone (therapeutic use)
• Middle Aged
• Prednisolone (therapeutic use)
• Pulse Therapy, Drug
• Recurrence
• Remission Induction
• Still's Disease, Adult-Onset (drug therapy)
• Tacrolimus (therapeutic use)