Rituximab therapy for refractory systemic-onset juvenile idiopathic arthritis

J Narváez¹, C Díaz-Torné², X Juanola¹, C Geli², J M Llobet², J M Nolla¹, C Díaz-López²

¹ Department of Rheumatology, Hospital Universitario de Bellvitge–IDIBELL, Barcelona, Spain
² Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

Correspondence to:
Dr F J Narváez García, Department of Rheumatology (planta 10–2), Hospital Universitario de Bellvitge, Feixa Llarga s/n 08907, L’Hospitalet de Llobregat, Barcelona, Spain; 31577edd@comb.es

Accepted 26 July 2008

The first 150 words of the full text of this article appear below.

Systemic-onset juvenile idiopathic arthritis (SOJIA), formerly called Still’s disease, is a subset of juvenile arthritis that describes patients with fever, rash, arthritis, serositis and visceromegaly. In up to 30% of cases the disease has a chronic course and management requires high doses of glucocorticoids, disease-modifying antirheumatic drugs (DMARD), tumour necrosis factor alpha (TNF) inhibitors or anakinra.^1–6 However, this therapeutic arsenal is unable to control the disease in all patients.

Recently, rituximab, a chimeric anti-CD20 monoclonal antibody, has been successfully used in two patients with refractory adult-onset Still’s disease.⁷ As the similarity of clinical and laboratory features present in SOJIA and adult-onset Still’s disease implies that these conditions have similar pathogenic mechanisms,^{1 2} we tested rituximab in three patients with severe active SOJIA who had an inadequate response or were intolerant to current treatment options. The patients’ main characteristics at rituximab treatment initiation and outcome data are summarised in table 1. . . [Full text of this article]

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