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  • Open Access

Tocilizumab in JIA patients who have inadequate response to anti-tumour necrosis factor therapy

Pediatric Rheumatology20119 (Suppl 1) :P186

https://doi.org/10.1186/1546-0096-9-S1-P186

  • Published:

Keywords

  • Infliximab
  • Etanercept
  • Adalimumab
  • Active Joint
  • Tocilizumab

Background

Tocilizumab (TCZ), an IL-6 receptor inhibitor, improves arthritis and systemic symptoms associated with systemic JIA. It may be a valuable option in patients with JIA who show inadequate response to anti-TNF agents.

Aim

To analyze the short-term effectiveness and safety of TCZ in patients with JIA refractory to anti-TNF agents.

Methods

All patients who received TCZ due to refractory disease were included. All patients had exhibited anti-TNF primary or secondary failure. Data were retrieved from the Rheumatology Section data base. TCZ was administered intravenously at a dose of 8 mg/kg for patients > 30 Kg, 12 mg/Kg for patients < 30 Kg every 2 weeks. Efficacy endpoints included improvement (ACR Pedi30), disappearance of systemic symptoms, and reduction in corticosteroid dose.

Results

9 patients with JIA (7 systemic, 2 poliarticular, 7 F, 2 M) were included. Median age at study entry was 10 years, disease duration 6 years. They received TCZ for 3 to 9 months. Patients had been refractory to etanercept (9), adalimumab (7) or infliximab (2). At baseline (medians): active joints: 11, joints with limited motion: 4, wellbeing (0-3): 0.1, disease activity (0-3): 0.45, ESR: 35 mm/h; CHAQ > 0.5 3 patients, fever/rash 1 patient. Six patients were receiving corticosteroids. All patients met improvement criteria, 7 before the 3rd TCZ infusion. At 1 month after TCZ therapy began: active joints: 4, joints with limited motion: 3, wellbeing: 0.05, disease activity: 0.24, ESR: 3 mm/h; CHAQ > 0.5 1 patient, fever/rash 0 patient. During the treatment, 4 patients reduced dose (< 50%) of corticosteroids. No side effects were recorded.

Conclusions

Tocilizumab seems to be effective and safe with a rapid onset of action in children with anti-TNF refractory JIA.

Authors’ Affiliations

(1)
Service of Immunology & Rheumatology, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina

Copyright

© Russo and Katsicas; licensee BioMed Central Ltd. 2011

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 (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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