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Tocilizumab for juvenile idiopathic arthritis: a single-center case series
Fatma Yazılıtaş1, Semanur Özdel2, Doğan Şimşek2
1MD. Physician and Pediatric Nephrologist, Department of Pediatric Nephrology, Dr. Sami Ulus Kadin Doğum Çocuk Sağliği ve Hastaliklari Eğitim ve Araştirma Hastanesi, Sağlik Bilimleri Üniversitesi, Ankara, Turkey.
Insights
Tocilizumab effectively treated juvenile idiopathic arthritis (JIA) in patients refractory to other therapies, showing significant symptom improvement and disease control. This biologic therapy is a viable option for resistant cases of polyarticular JIA (pJIA) and systemic JIA (sJIA).
Area of Science:
- Pediatric Rheumatology
- Immunology
- Pharmacology
Background:
- Juvenile idiopathic arthritis (JIA) is a prevalent chronic childhood rheumatic disease.
- Inadequate treatment of JIA can result in joint damage, functional disability, and long-term health issues.
Purpose of the Study:
- To evaluate the efficacy, safety, and tolerability of tocilizumab in pediatric patients with JIA.
- To assess tocilizumab's utility in polyarticular JIA (pJIA) and systemic JIA (sJIA) cases unresponsive to other treatments.
Main Methods:
- Retrospective observational case series involving 11 JIA patients treated with tocilizumab.
- Analysis of patient records for demographic data, clinical/laboratory findings, treatment response, and adverse events.
- Efficacy assessment using American College of Rheumatology (ACR) pediatric (Pedi) response criteria (ACR Pedi 30, 50, 70, 90).
Main Results:
- Tocilizumab was administered to seven sJIA and four pJIA patients.
- Most patients experienced symptom improvement, reduced inflammation, and achieved inactive disease.
- High response rates observed: 90.9% achieved ACR Pedi 30, 50, and 70 scores.
- Minor side effects were reported in five patients.
Conclusions:
- Tocilizumab is a beneficial treatment option for JIA patients.
- Consider tocilizumab for pJIA and sJIA patients resistant to conventional disease-modifying anti-rheumatic drugs (DMARDs) and/or other biologics.
Background:
Juvenile idiopathic arthritis (JIA) is the commonest chronic rheumatic disease among children. When not treated effectively, JIA can lead to functional disability, due to joint damage, along with long-term morbidities.
Objectives:
To describe the use of tocilizumab therapy for 11 patients with polyarticular JIA (pJIA) and systemic JIA (sJIA) who presented inadequate response or were refractory to disease-modifying anti-rheumatic drugs (DMARDs) and/or other biological therapies; and to evaluate its benefits, safety and tolerability.
Design And Setting:
Observational retrospective case series at a tertiary-level training and research hospital.
Methods:
We reviewed the medical records of 11 consecutive patients with JIA who received tocilizumab (anti-IL-6) therapy in our pediatric nephrology and rheumatology outpatient clinic. We analyzed their demographic data, clinical and laboratory findings, treatment response and adverse reactions. We determined the efficacy of tocilizumab treatment using the American College of Rheumatology (ACR) pediatric (Pedi) response criteria, including ACR Pedi 30, 50, 70 and 90 scores. We used the Wilcoxon test to compare measurements before and after treatment.
Results:
Tocilizumab was given to seven patients with sJIA and four with pJIA (one of the pJIA patients was rheumatoid factor-positive). In most patients, we observed improvement of symptoms, absence of articular and extra-articular inflammation and continued inactive disease. ACR Pedi 30, 50 and 70 scores were achieved by 90.9% of the patients. Five patients showed minor side effects, possibly due to use of tocilizumab.
Conclusions:
Tocilizumab therapy should be considered for treating patients with diagnoses of pJIA or sJIA who are resistant to non-biological DMARDs and/or other biological therapies.
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