Treatment with the anti-interleukin (IL)-6 receptor antibody tocilizumab (Actemra) led to rapid amelioration of arthritis and systemic symptoms in a small group of patients with refractory adult Still's disease.
The study of only 14 patients with the disease, the first series of patients to be treated with tocilizumab, found that the mean disease activity score in 28 joints (DAS28) decreased from a mean of 5.61 at baseline to 3.21 at three months and to 2.91 at six months, according to Xavier Puéchal, MD, PhD, of Le Mans General Hospital in Le Mans, France, and colleagues.
Adult Still's disease is characterized by destructive arthritis, high fevers, rash, and elevations in white cell count and acute-phase reactants.
The arthritis seen in adult Stills' disease is refractory to standard anti-rheumatic therapies such as steroids and methotrexate in many patients. While some patients have responded to tumor necrosis factor (TNF) inhibitors or anakinra (Kineret), efficacy has been inconsistent and adverse effects have been problematic.
Because a pathogenic role for IL-6 has been suggested in adult Still's disease and a few reports have suggested benefit for tocilizumab, Puéchal and colleagues conducted a study of all patients enrolled in a special protocol for off-label use of the drug between 2006 and 2009.
The study cohort of 14 patients had failed all available therapies, which in some cases included three TNF inhibitors, abatacept, and rituximab.
In eight of the patients, their arthritis had already led to irreversible joint damage. Recurrent systemic symptoms were present in seven.
http://www.medpagetoday.com/Rheumatology/GeneralRheumatology/24172I am 20 years old and i was diagnosed with adult onset still's disease in july 2009 and in march 2010 my condition was classed as chronic basically, i know myself how difficult. Adult still's disease improves with actemra actemra (tocilizumab) is used to treat and debilitating symptoms of the disease," said mark genovese, m d , actemra receptor inhibition with tocilizumab improves. Fda approves actemra for the treatment of moderately to severely fda) approved actemra (tocilizumab) for the treatment of adult patients symptoms of the disease," said mark genovese, m d , actemra study with tocilizumab improves. Well this could be great news for some people. Just thought I would bring it back up to the top.