Treatment of refractory adult-onset Still's disease with tocilizumab: report of two cases and review of the literature.
Adult-onset Still's disease (AOSD) is empirically treated with nonsteroidal anti-inflammatory drugs, corticosteroids, conventional disease-modifying antirheumatic drugs, tumor necrosis factor-blocking agents or anakinra. The monoclonal anti-interleukin (IL)-6 antibody tocilicumab (TOC) has recently been approved for the treatment of rheumatoid arthritis and may be an attractive therapeutic option for AOSD as well. We report two AOSD patients treated with TOC and review of the current data on the use of TOC in AOSD. TOC was applied to the first patient after failure of cloroquin, methotrexate, adalimumab and etanercept. The second patient received TOC because of inefficacious methotrexate treatment. TOC was well tolerated by both the patients, and no clinically significant side effects occurred. Including these two cases, a total of seven AOSD patients have been successfully treated with TOC so far. TOC may be a promising treatment option for AOSD patients refractory to conventional disease-modifying antirheumatic drugs anakinra and tumor necrosis factor-[Formula: see text].
Department of Internal Medicine, State Hospital Muerzzuschlag, Grazer Strasse 63-65, 8680 Muerzzuschlag, Austria. rene.thonhofer@pro.medunigraz.at
Rene
R
Thonhofer
Manuela
M
Hiller
Horst
H
Just
Markus
M
Trummer
Cornelia
C
Siegel
Christian
C
Dejaco
D000068879:Adalimumab; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D016706:Still's Disease, Adult-Onset / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult; D000093242:Interleukin-6 Inhibitors
D000068879:Adalimumab; D000894:Anti-Inflammatory Agents, Non-Steroidal; D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D008727:Methotrexate; D011239:Prednisolone; D000093242:Interleukin-6 Inhibitors; C502936:tocilizumab
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