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Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder of unknown aetiology.1 Based on the substantial acute phase responses observed in AOSD, we hypothesised that blockade of the interleukin 6R (IL-6R), neutralising the induction of the acute phase response by IL-6, could be a useful treatment in multidrug-resistant AOSD. We here report on three patients with AOSD who were refractory to standard treatment and cytokine blockade with anakinra and tumour necrosis factor (TNF) blockers and were subjected to treatment with tocilizumab. The characteristics of these three patients are summarised in table 1.
A 19-year-old woman was first diagnosed with AOSD in July 2006. Prednisone therapy was started, but multiple relapses occurred during the following 2 years requiring …