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AB0697 Tocilizumab in systemic and polyarticular juvenile idiopathic arthritis: results of a retrospective evaluation in real-life clinical practice
  1. S. Bustabad1,
  2. J. J. Bethencourt2,
  3. M. Prieto Morales3,
  4. M. E. Peiro Callizo4,
  5. M. L. Gamir Gamir5
  1. 1Rheumatología
  2. 2Reumatología, Hospital Universitario de Canarias, La Laguna
  3. 3Reumatología, Hospital Universitario Ramón y Cajal, Madrid
  4. 4Reumatología, Hospital Universitario Marqués de Valdecilla, Santander
  5. 5Reumatología, Hospital Universitairo Ramón y Cajal, Madrid, Spain

Abstract

Background Interleukin-6 (IL-6) is a proinflammatory cytokine that is overexpressed in patients with Juvenile Idiopathic Arthritis (JIA). A key role of this cytokine in the pathogenesis of such group of chronic arthropathies has been described. Tocilizumab (TCZ), a humanized anti-human IL-6 receptor antibody, has been demonstrated effective in systemic JIA (sJIA). Here, we report the results of the retrospective evaluation of a series of patients with sJIA or polyarticular JIA (pJIA) who received tocilizumab within a compassionate use program. in Spain.

Objectives Multicenter, retrospective study of a series of 14 patients with sJIA or pJIA treated with TCZ as compassionate use after methrotrexate failure (n=9) or, anti-TNF and abatacept therapy failure (n=5). sJIA patients weighing≥ 30 kg received 8 mg/kg of tocilizumab once every 2 weeks and those weighing< 30 kg received 12 mg/kg of tocilizumab once every 2 weeks. pJIA patients received 8 mg/kg/month. Efficacy and safety endpoints included laboratory parameters, joint counts and corticosteroids use.

Methods Multicenter, retrospective study of a series of 14 patients with sJIA or pJIA treated with TCZ as compassionate use after methrotrexate failure (n=9) or, anti-TNF and abatacept therapy failure (n=5). sJIA patients weighing≥ 30 kg received 8 mg/kg of tocilizumab once every 2 weeks and those weighing< 30 kg received 12 mg/kg of tocilizumab once every 2 weeks. pJIA patients received 8 mg/kg/month. Efficacy and safety endpoints included laboratory parameters, joint counts and corticosteroids use.

Results A total of 7 sJIA (5 females and 2 males) and 7 pJIA (5 females and 2 males) were evaluated. Median age of sJIA patients was 14 years (range, 6 to 34) and median disease duration was 6 years (range, 0.5 to 31). As for the pJIA patients, median age was 10 years (range, 3 to 16) and median disease duration was 1.9 years (range, 0.5 to 12). Before starting TCZ therapy, all sJIA patients and 4 pJIA patients were receiving corticosteroids (mean dose was 15 and 9 mg/day, respectively). Median (range) values of laboratory parameters at baseline and at 1, 3 and 6 months are displayed in Table 1. The mean percent reduction from baseline in swollen joint count (SJC) after the first month of TCZ therapy was 85.7% (±17.0) and 79.7% (±36.1) in sJIA patients and pJIA patients, respectively. Most patients presented a 100% reduction in SJC in both groups of patients after 6 months of therapy. Among all patients analyzed, only one patient with pJIA was receiving corticosteroids at 6 months. The incidence of infections was 20%, no serious infections were reported. There were no significant changes in cholesterol and triglycerides levels during TCA therapy.

Conclusions TCZ is very effective and well tolerated in patients with sJIA and pJIA in real-life clinical practice. A markedly decline in signs and symptoms of JIA was observed after one month of treatment. TCZ has been recently approved to treat sJIA patients. Our results also indicate that TCZ should be also considered in pJIA patients.

Disclosure of Interest None Declared

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