Abstract | BACKGROUND: METHODS: Thirty-seven active SoJIA children who have failed treatment with corticosteroids and other DMARDs were included in our retrospective study. TCZ doses were prescribed in two treatment approaches: every 2 weeks TCZ dosing (Q2W) and every 4 weeks TCZ dosing (Q4W). The patients were assigned to these two groups by the study physicians depending on the severity of the SoJIA disease as judged by each clinician. RESULTS: Thirty-three of the 37 children successfully completed the trial. TCZ was discontinued in 11patients during the trial. Seven children achieved inactive disease and were allowed to stop the TCZ and 4 had severe adverse events requiring drug cessation. Currently 7 patients continue to have TCZ-free remission [4/7 remission off-medication, 3/7still on methotrexate (MTX)]. This mixed group had a median treatment duration of 1002 days. The children in remission off of all medications, TCZ and MTX, had a median remission duration of 1162 days (ranged 932-1301 days). Compared to the patients assigned to the Q2W TCZ treatment group, the patients assigned to the Q4W TCZ group had a milder SoJIA course. The patients had higher levels of hemoglobin, total proteins, and serum albumins. They had lower white blood cell counts (WBC), % granulocytes, CRP, ESR, ferritins, and LDH. These children had a lower frequency of internal organ involvement, fewer relapses during TCZ treatment, and no macrophage activation syndrome episodes. CONCLUSIONS: Our experience with TCZ for SoJIA supports the excellent result of other studies. What may be novel is our finding that thisIL-6 blockade with TCZ may be able to be utilized at a less frequent dosing schedule in mild SoJIA compared to severe SoJIA. We discuss other factors that may increase the probability of a patient reaching TCZ-free remission.
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Authors | Mikhail M Kostik, Margarita F Dubko, Vera V Masalova, Ludmila S Snegireva, Tatyana L Kornishina, Irina A Chikova, Eugenia A Isupova, Ekaterina M Kuchinskaya, Natalia I Glebova, Natalia V Buchinskaya, Olga V Kalashnikova, Vyacheslav G Chasnyk |
Journal | Pediatric rheumatology online journal
(Pediatr Rheumatol Online J)
Vol. 13
Pg. 4
( 2015)
ISSN: 1546-0096 [Electronic] England |
PMID | 25685108
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Antibodies, Monoclonal, Humanized
- Interleukin-6
- tocilizumab
- Methotrexate
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Topics |
- Age of Onset
- Antibodies, Monoclonal, Humanized
(immunology, therapeutic use)
- Arthritis, Juvenile
(drug therapy, epidemiology)
- Child
- Cohort Studies
- Dose-Response Relationship, Drug
- Female
- Humans
- Interleukin-6
(antagonists & inhibitors, immunology)
- Male
- Methotrexate
(therapeutic use)
- Remission, Spontaneous
- Retrospective Studies
- Severity of Illness Index
- Time Factors
- Treatment Outcome
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