Efficacy of tocilizumab therapy in Korean patients with adult-onset Still's disease

A multicentre retrospective study of 22 cases

Seung Taek Song, Jin Ju Kim, Seung Lee, Hyoun Ah Kim, Eun Young Lee, Ki Chul Shin, Joo Hyun Lee, Kwanghoon Lee, Sang Tae Choi, Hoon Suk Cha, Dae Hyun Yoo

Research output: Contribution to journalArticle

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Abstract

Objective. To evaluate the efficacy of tocilizumab (TCZ), a monoclonal antibody against the interleukin (IL)-6 receptor, for refractory adult-onset Still's disease (AOSD) in the Korean population. Methods. This retrospective study included 22 Korean patients with refractory AOSD who were given TCZ at one of seven university hospital-based clinics for rheumatic disease. Patients were subdivided into groups according to disease course: monocyclic, systemic polycyclic, and chronic articular. Modified Pouchot scores, including laboratory and clinical findings, were analysed at 6 months and 12 months. Results. TCZ was given at 4-8 mg/kg every 4-5 weeks (8 mg/kg every 4-5 weeks in 18 patients, 6 mg/kg every 4 weeks in 2, and 4 mg/kg every 4 weeks in 2) for 7.5 months (median, IQR: 4.0-12.3). A good response (measured as a decrease of > 2 in the modified Pouchot score) was achieved in 50.0% of patients (11 of 22) at 6 months and in 64.3% (9 of 14) at 12 months. The dose of corticosteroid dose was reduced from 11.5 mg/day (median, IQR: 10.0-21.3) immediately before TCZ therapy to 7.5 mg/day (median, IQR: 5.0-10.0, p = 0.002) at 6 months and finally to 6.3 mg/day (median, IQR: 5.0-7.5, p = 0.002) at 12 months. Only one patient discontinued TCZ treatment due to facial swelling accompanied by high blood pressure. In all others, adverse events subsided with delayed TCZ therapy, and TCZ therapy was continued successfully without problems. Conclusion. TCZ was effective for treating Korean AOSD patients who were refractory to conventional therapy or other anti-cytokine biologics, showing a corticosteroid-sparing effect and an acceptable tolerance profile.

Original languageEnglish
Pages (from-to)64-71
Number of pages8
JournalClinical and Experimental Rheumatology
Volume34
Publication statusPublished - 2016 Jan 1

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Adult-Onset Still's Disease
Multicenter Studies
Retrospective Studies
Therapeutics
Adrenal Cortex Hormones
Interleukin-6 Receptors
tocilizumab
Rheumatic Diseases
Biological Products
Joints
Monoclonal Antibodies
Cytokines
Hypertension

All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

Song, Seung Taek ; Kim, Jin Ju ; Lee, Seung ; Kim, Hyoun Ah ; Lee, Eun Young ; Shin, Ki Chul ; Lee, Joo Hyun ; Lee, Kwanghoon ; Choi, Sang Tae ; Cha, Hoon Suk ; Yoo, Dae Hyun. / Efficacy of tocilizumab therapy in Korean patients with adult-onset Still's disease : A multicentre retrospective study of 22 cases. In: Clinical and Experimental Rheumatology. 2016 ; Vol. 34. pp. 64-71.
@article{789e2cd062304b588e4571f503afde5f,
title = "Efficacy of tocilizumab therapy in Korean patients with adult-onset Still's disease: A multicentre retrospective study of 22 cases",
abstract = "Objective. To evaluate the efficacy of tocilizumab (TCZ), a monoclonal antibody against the interleukin (IL)-6 receptor, for refractory adult-onset Still's disease (AOSD) in the Korean population. Methods. This retrospective study included 22 Korean patients with refractory AOSD who were given TCZ at one of seven university hospital-based clinics for rheumatic disease. Patients were subdivided into groups according to disease course: monocyclic, systemic polycyclic, and chronic articular. Modified Pouchot scores, including laboratory and clinical findings, were analysed at 6 months and 12 months. Results. TCZ was given at 4-8 mg/kg every 4-5 weeks (8 mg/kg every 4-5 weeks in 18 patients, 6 mg/kg every 4 weeks in 2, and 4 mg/kg every 4 weeks in 2) for 7.5 months (median, IQR: 4.0-12.3). A good response (measured as a decrease of > 2 in the modified Pouchot score) was achieved in 50.0{\%} of patients (11 of 22) at 6 months and in 64.3{\%} (9 of 14) at 12 months. The dose of corticosteroid dose was reduced from 11.5 mg/day (median, IQR: 10.0-21.3) immediately before TCZ therapy to 7.5 mg/day (median, IQR: 5.0-10.0, p = 0.002) at 6 months and finally to 6.3 mg/day (median, IQR: 5.0-7.5, p = 0.002) at 12 months. Only one patient discontinued TCZ treatment due to facial swelling accompanied by high blood pressure. In all others, adverse events subsided with delayed TCZ therapy, and TCZ therapy was continued successfully without problems. Conclusion. TCZ was effective for treating Korean AOSD patients who were refractory to conventional therapy or other anti-cytokine biologics, showing a corticosteroid-sparing effect and an acceptable tolerance profile.",
author = "Song, {Seung Taek} and Kim, {Jin Ju} and Seung Lee and Kim, {Hyoun Ah} and Lee, {Eun Young} and Shin, {Ki Chul} and Lee, {Joo Hyun} and Kwanghoon Lee and Choi, {Sang Tae} and Cha, {Hoon Suk} and Yoo, {Dae Hyun}",
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Song, ST, Kim, JJ, Lee, S, Kim, HA, Lee, EY, Shin, KC, Lee, JH, Lee, K, Choi, ST, Cha, HS & Yoo, DH 2016, 'Efficacy of tocilizumab therapy in Korean patients with adult-onset Still's disease: A multicentre retrospective study of 22 cases', Clinical and Experimental Rheumatology, vol. 34, pp. 64-71.

Efficacy of tocilizumab therapy in Korean patients with adult-onset Still's disease : A multicentre retrospective study of 22 cases. / Song, Seung Taek; Kim, Jin Ju; Lee, Seung; Kim, Hyoun Ah; Lee, Eun Young; Shin, Ki Chul; Lee, Joo Hyun; Lee, Kwanghoon; Choi, Sang Tae; Cha, Hoon Suk; Yoo, Dae Hyun.

In: Clinical and Experimental Rheumatology, Vol. 34, 01.01.2016, p. 64-71.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Efficacy of tocilizumab therapy in Korean patients with adult-onset Still's disease

T2 - A multicentre retrospective study of 22 cases

AU - Song, Seung Taek

AU - Kim, Jin Ju

AU - Lee, Seung

AU - Kim, Hyoun Ah

AU - Lee, Eun Young

AU - Shin, Ki Chul

AU - Lee, Joo Hyun

AU - Lee, Kwanghoon

AU - Choi, Sang Tae

AU - Cha, Hoon Suk

AU - Yoo, Dae Hyun

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Objective. To evaluate the efficacy of tocilizumab (TCZ), a monoclonal antibody against the interleukin (IL)-6 receptor, for refractory adult-onset Still's disease (AOSD) in the Korean population. Methods. This retrospective study included 22 Korean patients with refractory AOSD who were given TCZ at one of seven university hospital-based clinics for rheumatic disease. Patients were subdivided into groups according to disease course: monocyclic, systemic polycyclic, and chronic articular. Modified Pouchot scores, including laboratory and clinical findings, were analysed at 6 months and 12 months. Results. TCZ was given at 4-8 mg/kg every 4-5 weeks (8 mg/kg every 4-5 weeks in 18 patients, 6 mg/kg every 4 weeks in 2, and 4 mg/kg every 4 weeks in 2) for 7.5 months (median, IQR: 4.0-12.3). A good response (measured as a decrease of > 2 in the modified Pouchot score) was achieved in 50.0% of patients (11 of 22) at 6 months and in 64.3% (9 of 14) at 12 months. The dose of corticosteroid dose was reduced from 11.5 mg/day (median, IQR: 10.0-21.3) immediately before TCZ therapy to 7.5 mg/day (median, IQR: 5.0-10.0, p = 0.002) at 6 months and finally to 6.3 mg/day (median, IQR: 5.0-7.5, p = 0.002) at 12 months. Only one patient discontinued TCZ treatment due to facial swelling accompanied by high blood pressure. In all others, adverse events subsided with delayed TCZ therapy, and TCZ therapy was continued successfully without problems. Conclusion. TCZ was effective for treating Korean AOSD patients who were refractory to conventional therapy or other anti-cytokine biologics, showing a corticosteroid-sparing effect and an acceptable tolerance profile.

AB - Objective. To evaluate the efficacy of tocilizumab (TCZ), a monoclonal antibody against the interleukin (IL)-6 receptor, for refractory adult-onset Still's disease (AOSD) in the Korean population. Methods. This retrospective study included 22 Korean patients with refractory AOSD who were given TCZ at one of seven university hospital-based clinics for rheumatic disease. Patients were subdivided into groups according to disease course: monocyclic, systemic polycyclic, and chronic articular. Modified Pouchot scores, including laboratory and clinical findings, were analysed at 6 months and 12 months. Results. TCZ was given at 4-8 mg/kg every 4-5 weeks (8 mg/kg every 4-5 weeks in 18 patients, 6 mg/kg every 4 weeks in 2, and 4 mg/kg every 4 weeks in 2) for 7.5 months (median, IQR: 4.0-12.3). A good response (measured as a decrease of > 2 in the modified Pouchot score) was achieved in 50.0% of patients (11 of 22) at 6 months and in 64.3% (9 of 14) at 12 months. The dose of corticosteroid dose was reduced from 11.5 mg/day (median, IQR: 10.0-21.3) immediately before TCZ therapy to 7.5 mg/day (median, IQR: 5.0-10.0, p = 0.002) at 6 months and finally to 6.3 mg/day (median, IQR: 5.0-7.5, p = 0.002) at 12 months. Only one patient discontinued TCZ treatment due to facial swelling accompanied by high blood pressure. In all others, adverse events subsided with delayed TCZ therapy, and TCZ therapy was continued successfully without problems. Conclusion. TCZ was effective for treating Korean AOSD patients who were refractory to conventional therapy or other anti-cytokine biologics, showing a corticosteroid-sparing effect and an acceptable tolerance profile.

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