Buscar

Estamos realizando la búsqueda. Por favor, espere...

 Detalle_Publicacion

Efficacy of tocilizumab in conventional treatment-refractory adult-onset Still's disease: multicenter retrospective open-label study of thirty-four patients.

Abstract: OBJECTIVE: Adult-onset Still's disease (AOSD) is frequently refractory to standard therapy. Tocilizumab (TCZ) has demonstrated efficacy in single cases and in small series of patients with AOSD. The aim of this multicenter study was to assess the efficacy of TCZ in patients with AOSD refractory to conventional treatment. METHODS: This was a retrospective open-label study of TCZ treatment in 34 patients with AOSD who had experienced an inadequate response to corticosteroids and at least 1 standard synthetic immunosuppressive drug and also, in many cases, biologic agents. RESULTS: The mean ± SD age of the patients (8 men and 26 women) was 38.7 ± 16.1 years. The median duration of AOSD before TCZ was initiated was 4.2 years (interquartile range [IQR] 1-9 years). The initial dosages of intravenous TCZ were 8 mg/kg every 4 weeks in 22 patients, 4 mg/kg every 4 weeks in 2 patients, and 8 mg/kg every 2 weeks in 10 patients. TCZ treatment resulted in rapid and maintained improvement in both clinical and laboratory parameters. After 1 year of TCZ therapy, the incidence of joint manifestations had decreased from 97.1% at baseline to 32.4%, the incidence of both cutaneous manifestations and fever had decreased from 58.8% to 5.9%, and the incidence of lymphadenopathy had decreased from 29.4% to 0%. A dramatic reduction in laboratory markers of inflammation, including the C-reactive protein level, the erythrocyte sedimentation rate, and the ferritin level, was achieved. The median dosage of prednisone was also reduced, from 13.8 mg/day (IQR 5-45) at the initiation of TCZ to 2.5 mg/day (IQR 0-30) at 12 months. After a median followup of 19 months (IQR 12-31 months), only 2 patients required permanent discontinuation of TCZ therapy because of severe infections. CONCLUSION: TCZ treatment was associated with rapid and maintained clinical and laboratory improvement in patients with AOSD refractory to standard treatment. However, joint manifestations seem to be more refractory to treatment compared with systemic manifestations.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: Arthritis Rheumatol. 2014 Jun;66(6):1659-65

Editorial: John Wiley and Sons Ltd

 Fecha de publicación: 01/06/2014

Nº de páginas: 7

Tipo de publicación: Artículo de Revista

 DOI: 10.1002/art.38398

ISSN: 2326-5205,2326-5191

Proyecto español: RD08/0075 ; RD12/0009/0013

Autores/as

ORTIZ SANJUÁN, FRANCISCO

RICARDO BLANCO ALONSO

CALVO RIO, VANESA

NARVAEZ, JAVIER

RUBIO ROMERO, ESTEBAN

OLIVE, ALEJANDRO

CASTAN˜EDA, SANTOS

GALLEGO FLORES, ADELA

HERNÁNDEZ, M. VICTORIA

MATA, CRISTINA

ROS VILAMAJO, INMACULADA

SIFUENTES GIRALDO, WALTER ALBERTO

CARACUEL, MIGUEL A.

FREIRE, MERCEDES

GÓMEZ ARANGO, CATALINA

JAVIER RUEDA GOTOR

PINA MURCIA, TRINITARIO