Vol.19 No.1

Case Report

A case report of a patient with refractory adult-onset Still’s disease who was successfully treated with tocilizumab over 6 years

Authors

Hideko Nakahara1,2 , Toru Mima1 , Naoko Yoshio-Hoshino1 , Masato Matsushita3 , Jun Hashimoto4 , Norihiro Nishimoto1

  • Laboratory of Immune Regulation, Graduate School of Frontier Biosciences, Osaka University, 1-3 Yamada-oka, Suita, Osaka 565-0871, Japan
  • NTT West Osaka Hospital, 2-6-40 Karasugatsuji, Tennoji-ku, Osaka Osaka, 543-8922, Japan
  • Division of Rheumatology, National Hospital Organization, Osaka Minami Medical Center, 2-1 Kidohigashi-cho, Kawachinagano, Osaka 586-8521, Japan
  • Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan
Received:

25 April 2008

Accepted:

22 July 2008

Published online:

2 September 2008

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Abstract

Interleukin-6 overproduction is pathologically involved in adult onset Still’s disease (AOSD). We successfully treated a man with refractory AOSD utilizing tocilizumab. Tocilizumab was discontinued after 15 doses due to intestinal bleeding, but the efficacy was sustained over 21 months. Tocilizumab was readministered safely upon recurrence and showed similar efficacy over 6 years. Corticosteroid and NSAIDs could be discontinued and intestinal bleeding was no more observed. Tocilizumab can be a therapeutic option for AOSD.

Key words

Anti-IL-6 receptor antibody - Biologics - IL-6 - Remission - AOSD