Tocilizumab in Refractory Adult-Onset Still's Disease with Aseptic Meningitis—Efficacy of Interleukin-6 Blockade and Review of the Literature

Sabnis, Girish; Gokhale, Yojana; Kulkarni, Uday

doi:10.1016/j.semarthrit.2010.05.003

Cited by 31 publications

(8 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…187–190 Although the efficacy and safety of TCZ for AOSD have not yet been evaluated in a randomized controlled trial, numerous case and pilot studies have shown that TCZ treatment improved clinical symptoms and signs of AOSD in patients who had been refractory to conventional treatment regimens and biologics, including TNF inhibitors and anakinra. 191–207 These findings indicate that TCZ may become a first-line biologic for the treatment of AOSD.…”

Section: Additional Applications Of Tocilizumab For Other Immune-medimentioning

confidence: 86%

Tocilizumab: An Updated Review of Its Use in the Treatment of Rheumatoid Arthritis and Its Application for Other Immune-Mediated Diseases

Tanaka

Ogata

Narazaki

2013

Clinical Medicine Insights: Therapeutics

View full text Add to dashboard Cite

Interleukin-6 (IL-6), produced by a variety of cells, is a typical cytokine featuring redundancy and pleiotropic activity. IL-6 is promptly and transiently synthesized in response to infections or injuries, and participates in host defense by inducing immune responses, hematopoiesis, and acute-phase reactions. However, since its abnormal persistent production of mostly unknown etiology plays an important pathological role in the development of various immune-mediated diseases, a humanized anti-IL-6 receptor monoclonal antibody, tocilizumab, was developed and is now used as an innovative biologic for rheumatoid arthritis in more than 90 countries. Several factors strongly suggest that a IL-6 blockade strategy may have a broad application for the treatment of various immune-mediated diseases. These factors include favorable results of pilot or case studies with off-label use of tocilizumab, pathological analyses of the contribution of IL-6 to the development of immune-mediated diseases, and the potential capability of tocilizumab to both repair an imbalance of effector T cell subsets and to suppress pathologic autoantibody production. However, clinical trials to evaluate the efficacy and safety of tocilizumab for these diseases are essential. Furthermore, clarification of the cell source of IL-6 production and of the mechanisms through which dysregulated continuous IL-6 synthesis is induced constitutes an important issue for future studies into the pathogenesis of diseases.

show abstract

Section: Additional Applications Of Tocilizumab For Other Immune-medimentioning

confidence: 86%

Tocilizumab: An Updated Review of Its Use in the Treatment of Rheumatoid Arthritis and Its Application for Other Immune-Mediated Diseases

Tanaka

Ogata

Narazaki

2013

Clinical Medicine Insights: Therapeutics

View full text Add to dashboard Cite

show abstract

“…In addition, they histologically revealed that IL-18 was highly expressed by activated CD68 + liver macrophages and Kupffer cells in a patient with AOSD [25]. It has been known that hyperferritinemia in AOSD patients is primarily due to increased secretion in the liver and spleen in patients with AOSD [22,31]. In a case report, Motoo et al demonstrated that the increased serum LDH during AOSD are-up was mainly of liver origin (LDH isoenzymes 4 and 5) [30].…”

Section: Discussionmentioning

confidence: 99%

Different Features of Interleukin-37 and Interleukin-18 as Disease Activity Markers of Adult-onset Still’s Disease

Nam

Kang

Lee

et al. 2021

Preprint

View full text Add to dashboard Cite

Backgrounds/Aims: The aim of this study was to evaluate the usefulness of serum interleukin (IL)-37 and IL-18 as disease activity markers of adult-onset Still’s disease (AOSD) and to compare their related clinical features. Methods: Forty-five patients with a set of high and subsequent low disease activity status of AOSD that fall within a 12-month period were enrolled. Modified Pouchot (mPouchot) score and serologic disease activity markers including serum levels of IL-37 and IL-18 were compared between high and low disease activity status. The relationships between disease activity parameters and differences in serum levels of IL-37 and IL-18 according to the presence of each disease manifestation of AOSD were evaluated in high disease activity status. Results: mPouchot score and all serologic disease activity markers including ESR, CRP, ferritin, IL-37, and IL-18 significantly declined in low disease activity status (p<0.01). Though both serologic cytokines positively correlated with mPouchot score, the two did not correlate with each other in high disease activity status. IL-18 positively correlated with ferritin, AST, and LDH (p<0.05). In contrast, IL-37 correlated better with CRP (p<0.01). The expression level of IL-37 and presence of leukocytosis were closely related. However, the expression level of IL-18 was closely related to presence of pleuritis. pneumonitis, abnormal LFT, and hyperferritinemia. Conclusions: Both IL-37 and IL-18 can be useful serologic markers of AOSD activity, but their pathologic roles in disease activity might be different.

show abstract

“…Rare manifestations with single case reports include adult respiratory distress syndrome [28], ischemic stroke, reversible posterior leukoencephalopathy syndrome [29], bilateral perception of deafness [30], aseptic meningitis or encephalitis [31][32][33][34][35], collapsing glomerulopathy [36,37], membranous glomerulonephritis [38] and more. Even rarer are complications like thrombotic thrombocytopenic purpura, pure red cell aplasia, and neurological complications, such as cranial nerve palsies, seizures, aseptic meningoencephalitis, and Miller-Fisher syndrome [10,13,17,[39][40][41][42][43].…”

Section: Discussionmentioning

confidence: 99%

Seizing the clinical presentation in adult onset Still's disease. An extensive literature review

Narula

Abril

2015

Autoimmunity Reviews

View full text Add to dashboard Cite

Tocilizumab in Refractory Adult-Onset Still's Disease with Aseptic Meningitis—Efficacy of Interleukin-6 Blockade and Review of the Literature

Cited by 31 publications

References 11 publications

Tocilizumab: An Updated Review of Its Use in the Treatment of Rheumatoid Arthritis and Its Application for Other Immune-Mediated Diseases

Tocilizumab: An Updated Review of Its Use in the Treatment of Rheumatoid Arthritis and Its Application for Other Immune-Mediated Diseases

Different Features of Interleukin-37 and Interleukin-18 as Disease Activity Markers of Adult-onset Still’s Disease

Seizing the clinical presentation in adult onset Still's disease. An extensive literature review

Contact Info

Product

Resources

About