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The efficacy and safety of Tocilizumab in adults with refractory systemic onset JIA


Systemic-onset JIA (so-JIA) is often persisting into adulthood and can be refractory to treatment including biologicals. We report on efficacy and safety of Tocilizumab in adults with persistent active so-JIA in a retrospective single center descriptive cohort study.

Patients and methods

Disease activity scores (DAS-CRP), ESR and CRP were measured just before and at 1- 6- and 12 months of Tocilizumab treatment in all adults with refractory so-JIA at our University Hospital. Adverse events were recorded.


Eight patients (5 women, 3 men) with a median age of 27,5yr and median disease duration of 16 yr were treated. All previously failed Methotrexate, other classical DMARD’s, 7/8 also failed on one or more biologicals (mostly TNF blockers, Anakinra in 1). Median HAQ before starting Tocilizumab was 1.25 (0.75-2.13). Tocilizumab dose was 8mg/kg/month, except for 1 patient receiving 6mg/kg/2 weeks. The median DAS-CRP decreased from 5,10(1.6-5.3) (n=6) at start to 2,25(1.3-2.9) (n=6) after six months (p=0,046). At 12 months, median DAS-CRP was 1,9(1.5-6.1)(n=3). Median ESR/CRP decreased from 35(15-87)(n=6)/69,2(9.1-292.6)mg/l(n=8) at start to

2(1-7)/1,2(0.6-1.4)mg/l(n=7) at six months (p=0,028/0,018). At 1 year median ESR/CRP were 3,5(1-13)(n=4)/0,6(0.6-23.1)mg/l(n=5). A decrease/complete stop of steroids was observed in 6 patients. Atypical rash was seen in one patient, EBV-induced MAS occurred in 1 patient after 7 yrs of Tocilizumab.


Our report on young adults with persistingly active so-JIA treated with Tocilizumab shows a fast, steep and persistent decrease in disease activity up to at least 1 year, demonstrating the efficacy of IL6-receptor antagonism also in patients with long-standing refractory so-JIA.

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Correspondence to G Deslypere.

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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Deslypere, G., Wouters, C., Joly, J. et al. The efficacy and safety of Tocilizumab in adults with refractory systemic onset JIA. Pediatr Rheumatol 9 (Suppl 1), P137 (2011).

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