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

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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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All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

Song, S. T., Kim, J. J., Lee, S., Kim, H. A., Lee, E. Y., Shin, K. C., Lee, J. H., Lee, K., Choi, S. T., Cha, H. S., & Yoo, D. H. (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, 34, 64-71.