[Sustained response with tocilizumab in a case of refractory relapsing polychondritis].
BACKGROUND
Relapsing polychondritis (RP) is a rare inflammatory disease characterized by diffuse cartilage involvement, especially those of the respiratory tract, leading to potentially life threatening complications. Corticosteroids remain the first-line empirical therapy. Immunosuppressive drugs such as azathioprine, cyclophosphamide and tumor necrosis factor blockers (anti-TNFα) are commonly used as second-line therapy with varying degrees of success.


METHODS
We report a 40-year-old man with severe RP for whom conventional therapy and immunosuppressive treatments were ineffective. Prolonged clinical remission was obtained after introduction of the anti-interleukin-6 receptor antibody (tocilizumab), which was perfectly tolerated and allowed to taper steroids and methotrexate to a very low dosage.


CONCLUSIONS
Our patient is the fifth published one documenting the efficacy of tocilizumab in severe refractory RP, which strengthens the use of anti-IL-6 in that indication.
Service de médecine interne, hôpital Nord, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
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Weber
Service de médecine interne, hôpital Nord, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
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Gaultier
Laboratoire d'immunologie, hôpital Nord, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
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S
Paul
Service de médecine interne, hôpital Nord, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
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Guichard
Service de médecine interne, hôpital Nord, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
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E
Monard
Service de médecine interne, hôpital Nord, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France. Electronic address: pascal.cathebras@chu-st-etienne.fr.
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Cathébras
D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D004351:Drug Resistance / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D011081:Polychondritis, Relapsing / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; C502936:tocilizumab
Biologics; Biothérapies; Polychondrite atrophiante; Relapsing polychondritis; Tocilizumab