Tocilizumab treatment in juvenile idiopathic arthritis patients: A single center experience

Özet

Tocilizumab is a monoclonal antibody against interleukin-6 that has recentlyemerged as an alternative treatment modality for juvenile idiopathic arthritis(JIA). In the present study, we aimed to discuss the clinical and laboratoryfindings and treatment response of JIA cases to tocilizumab therapy. Thisretrospective study included 20 JIA patients aged between 0-18 years whowere followed up from 2014 to 2016 and received tocilizumab treatmentin our clinic. Treatment response could be not evaluated in two patientssince they developed anaphylactic reactions due to tocilizumab. Of theremaining 18 patients, seven of them (38.9%) had polyarticular JIA, andeleven (61.1%) had systemic JIA. Platelet counts, erythrocyte sedimentationrate and C-Reactive protein (CRP) levels, active joint counts, and JuvenileArthritis Disease Activity Score 71 (JADAS71) were significantly decreasedat the third month in both polyarticular and systemic JIA, while there werenot any significant differences between the third and sixth months. All of thepatients with polyarticular JIA had low disease activity at six months. Eightpatients with systemic JIA had an inactive disease at six months, whereasthe remaining three patients had high levels of CRP without presence ofany clinical symptoms. Steroid treatment was terminated at the sixth monthin all patients except for three patients who continued to receive 0.05-0.25mg/kg steroid treatment. Two patients developed thrombocytopenia, onepatient developed macrophage activation syndrome, and one patient hadelevated transaminases due to tocilizumab treatment. Previous studies haveshown that tocilizumab treatment is well-tolerated, effective, and safe foruse in JIA patients. In the present study, we also demonstrated the efficacyof tocilizumab treatment in JIA patients from our clinic.