The effect of tocilizumab on preventing relapses in adult-onset Still's disease: A retrospective, single-center study.
OBJECTIVE
To investigate the clinical effectiveness of tocilizumab (TCZ), a monoclonal antibody against the interleukin-6 receptor, in preventing relapse in patients with adult-onset Still's disease (AOSD).


METHODS
This retrospective study included clinical data from 40 patients who underwent regular follow-up at our institution in June 2013. Among these patients, 10 received TCZ. The relapse-free rate was analyzed by the Kaplan-Meier method.


RESULTS
The age at disease onset (median, interquartile range [IQR]) was 39 (29-52) years. The duration of disease in June 2013 (median, IQR) was 86 (41-193) months. A total of 87 relapses were documented in 27 patients. Ten patients with refractory or relapsing disease received 8 mg/kg of TCZ every 2-4 weeks. After 6 months of TCZ treatment, the median levels of C-reactive protein significantly decreased from 6.3 to 0.01 mg/dl (p < 0.01). Among these 10 patients, 11 relapses were observed before TCZ treatment, and none were observed after the treatment. The relapse-free rate of the 10 patients after starting TCZ was significantly higher than that of all 40 patients after the initial treatments (100% and 67% at 12 months, respectively; p = 0.03).


CONCLUSIONS
TCZ effectively prevented relapses of AOSD, and it resolved the disease activity.
Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo , Japan.
Naoshi
N
Nishina
Yuko
Y
Kaneko
Hideto
H
Kameda
Tsutomu
T
Takeuchi
D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D016706:Still's Disease, Adult-Onset / Q000188:drug therapy / Q000517:prevention & control*; D016896:Treatment Outcome
D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; C502936:tocilizumab
Adult-onset Still's disease; Glucocorticoids; Relapse; Tocilizumab