Acta Med. 2016, 59: 22-25

Efficacy of Low-Dose Tocilizumab on Relapsing Adult-Onset Still’s Disease

Xavier Vandemergela, Frédéric Vandergheynstb

aDepartment of General Internal Medicine, Centres Hospitaliers Jolimont, Nivelles, Belgium
bCUB Hôpital Erasme, Nivelles, Belgium

Received October 13, 2015
Accepted November 23, 2015

Still’s disease is an inflammatory disorder of unknown etiology. First-line therapy is based on corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) but the frequency of relapses and corticosteroid-induced adverse events are limiting factors. The efficacy of intravenous tocilizumab (TCZ) has been shown at a dose of 8 mg/kg but the corticosteroid-sparing effect of intravenous low-dose TCZ followed by subcutaneous (SC) injection in the course of the disease has been poorly investigated. We report the case of a 28-year old Caucasian woman presenting a relapse of Still’s disease eleven months after diagnosis under treatment with 6 mg of methylprednisolone. TCZ at a dose of 4 mg/kg every 2 weeks was combined with 32 mg of methylprednisolone, followed by 162 mg SC every 3 weeks. Evolution was rapidly favourable with a decrease in corticosteroid doses. We reviewed previously published cases.


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