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PILOT TRIAL OF TOCILIZUMAB FOR REFRACTORY PATIENTS WITH ADULT ONSET STILL'S DISEASE

Title
PILOT TRIAL OF TOCILIZUMAB FOR REFRACTORY PATIENTS WITH ADULT ONSET STILL'S DISEASE
Author
김태환
Issue Date
2013-06
Publisher
BMJ PUBLISHING GROUP
Citation
Annals of the Rheumatic Diseases, 2013, 72(3), P.322-322
Abstract
Background Adult onset Still’s disease (AOSD) is a systemic inflammatory disorder with unknown etiology. As therapeutic agents, traditional disease modifying anti-rheumatic drugs (DMARDs) or biological agents are suggested for patients unresponsive to corticosteroid. Among important cytokines for the AOSD pathogenesis, IL-6 plays a pivotal role. Several case reports have suggested that tocilizumab, a humanized anti-interleukin (IL)-6 receptor antibody was effective for intractable AOSD.Objectives Here, we described the clinical course of refractory Korean patients treated with tocilizumab therapy.Methods The 8 patients who were refractory to DMARDs and/or etarnecept or dependent to corticosteroid were enrolled for tocilizumab therapy after informed contents. Tocilizumab at 8mg/kg was administered every 4 weeks.Results Six females and 2 males were treated with tocilizumab. The mean age was 33.8 (26-47) years old. The frequency of tocilizumab therapy was an average of 6.3 (2-13) times. Almost patients showed complete (50.0%) or partial (37.5%) response to tocilizumab therapy except one patient (Table 1). The clinical symptoms improved in 4 weeks (mean), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) improved in 6.3 weeks, respectively. Serum ferritin, IL-18 and IL-6 levels slowly improved within 9.3 weeks, 12.5 weeks and 9.3 weeks, respectively. Three patients discontinued tocilizumab therapy although they showed improvement of clinical symptoms; because of severe headache and chest discomfort at 12 weeks, neutropenia at 8 weeks, and severe hepatotoxicity at 8 weeks, respectively. Other adverse events such as mild dizziness, hair loss, weight gain and transient leucopenia were observed and those were tolerable during follow-up.
URI
http://ard.bmj.com/content/72/Suppl_3/A322.1http://hdl.handle.net/20.500.11754/50682
ISSN
0003-4967
DOI
10.1136/annrheumdis-2013-eular.994
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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