TY - JOUR
T1 - Successful treatment of adult-onset Still's disease with tocilizumab monotherapy
T2 - Two case reports and literature review
AU - Sakai, Ryota
AU - Nagasawa, Hayato
AU - Nishi, Eiko
AU - Okuyama, Ayumi
AU - Takei, Hirofumi
AU - Kurasawa, Takahiko
AU - Kondo, Tsuneo
AU - Nishimura, Koji
AU - Shirai, Yuichiro
AU - Ito, Tatsuya
AU - Kameda, Hideto
AU - Takeuchi, Tsutomu
AU - Amano, Koichi
N1 - Funding Information:
Conflicts of interest H.K. has received honoraria from Mitsubishi-Tanabe Pharma, Pfizer, Abbott, Eisai Pharma, and Bristol-Myers KK. T.T. has received research support and consulting or lecture fees from Chugai Pharma. K.A. received research grants from Tanabe-Mitsubishi, Astellas, and Chugai pharmaceutical companies. The other authors have declared no conflicts of interest.
PY - 2012/3
Y1 - 2012/3
N2 - Adult-onset Still's disease (AOSD) is a systemic inflammatory disease of unknown etiology. Recently, it has been reported that quite a few cases of refractory AOSD were successfully treated with tocilizumab (TCZ) and corticosteroids were withdrawn in some of these patients. We report two AOSD patients who were treated successfully with TCZ monotherapy; thus, avoiding corticosteroid treatment. Because both of the patients refused to take corticosteroids, we planned to treat them with 8 mg/kg of TCZ monotherapy at weeks 0, 2, 6 and subsequently every 4 weeks. The efficacy of TCZ was assessed by patients' clinical symptoms such as fever, arthralgia, skin eruptions, and laboratory markers such as serum levels of CRP, ferritin, and IL-6. We also reviewed 14 previous case reports including 30 cases who had been treated with TCZ for AOSD. Our patients responded rapidly and have been maintained in clinical remission without corticosteroid treatment. In the literature review, concomitant corticosteroid treatment described in 13 cases was successfully tapered in 7 and discontinued in 6 cases. TCZ monotherapy can be a candidate for the first-line therapy for some AOSD patients.
AB - Adult-onset Still's disease (AOSD) is a systemic inflammatory disease of unknown etiology. Recently, it has been reported that quite a few cases of refractory AOSD were successfully treated with tocilizumab (TCZ) and corticosteroids were withdrawn in some of these patients. We report two AOSD patients who were treated successfully with TCZ monotherapy; thus, avoiding corticosteroid treatment. Because both of the patients refused to take corticosteroids, we planned to treat them with 8 mg/kg of TCZ monotherapy at weeks 0, 2, 6 and subsequently every 4 weeks. The efficacy of TCZ was assessed by patients' clinical symptoms such as fever, arthralgia, skin eruptions, and laboratory markers such as serum levels of CRP, ferritin, and IL-6. We also reviewed 14 previous case reports including 30 cases who had been treated with TCZ for AOSD. Our patients responded rapidly and have been maintained in clinical remission without corticosteroid treatment. In the literature review, concomitant corticosteroid treatment described in 13 cases was successfully tapered in 7 and discontinued in 6 cases. TCZ monotherapy can be a candidate for the first-line therapy for some AOSD patients.
KW - Adult-onset Still's disease
KW - Interleukin-6
KW - Monotherapy
KW - Tocilizumab
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U2 - 10.1007/s10067-011-1917-9
DO - 10.1007/s10067-011-1917-9
M3 - Article
C2 - 22215118
AN - SCOPUS:84859780892
SN - 0770-3198
VL - 31
SP - 569
EP - 574
JO - Clinical Rheumatology
JF - Clinical Rheumatology
IS - 3
ER -