engleski

Treatment of refractory adult onset Still’s disease with tocilizumab—a single centre experience and literature review

Adult-onset Still’s disease (AOSD) is defned as a systemic infammatory disorder of unknown aetiology and is classifed as a multigene autoinfammatory disease. Treatment of AOSD still remains mostly empirical with nonsteroidal anti-infammatory drugs, glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs or cyclosporin A. Inhibitors of tumour necrosis factor-alpha and interleukin-1 (IL-1) antagonists have shown efcacy in certain subsets of patients with AOSD. The IL-6 molecule is one of the potential targets in treating AOSD considering that its level is increased in both the systemic and chronic articular forms of the disease. We present a series of eight patients from our centre with refractory AOSD treated with tocilizumab (TCZ). The drug was administered intravenously (6–8 mg/kg every 3–4 weeks) or subcutaneously (162 mg weekly). One patient had a disease relapse during TCZ therapy, and the drug had to be withdrawn in one patient due to a severe infection, while fve out of six patients currently treated are in stable remission. Many previous reports have suggested that TCZ is an efcacious option for the treatment of refractory AOSD and the cases presented herein support this fnding. A literature search revealed two previous reports of subcutaneous TCZ administration TCZ in AOSD, and our experience supports subcutaneous TCZ as a promising option for treatment of refractory AOSD patients.

Still’s disease ; adult-onset ; Tocilizumab ; Interleukin-6 ; Disease-modifying antirheumatic drugs

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