Skip to main content Skip to main navigation menu Skip to site footer

Interleukin-6 receptor antagonist use in systemic juvenile idiopathic arthritis: a case report

Abstract

Systemic onset Juvenile Idiopathic Arthritis (JIA) accounts for approximately 4-15% of JIA, and has the worst prognosis. Treatment option in SJIA is still limited. Interleukin-6 receptor antagonist is the second line therapy, has been used widely in adult rheumatoid arthritis patients, but no report of pediatric population in Indonesia. To report the efficacy of interleukin-6 receptor antagonist-Tocilizumab in difficult to treat-SJIA management. An 11-years old boy was diagnosed with SJIA and treated with Ibuprofen, then switched to high dose pulse steroid therapy, continued by weekly methotrexate for 6 weeks, however flare up color the clinical manifestation. Following ACR Guideline 2013, tocilizumab every 2 weeks was started. After 4 weeks, the MD Global scores reduced from 10.7 to 3, ACR 70 was achieved, no systemic manifestations were found with normal lab result. Tocilizumab shows beneficial effects in SJIA patient

 

References

  1. Ringold S, Weiss PF, Beukelman T, DeWitt EM, Ilowite NT, Kimura Y et al. 2013 update of the 2011 American College of Rheumatology Recommendations for the Treatment of Juvenile Idiopathic Arthritis. American College of Rheumatology. 2013;65:2499-2512.
  2. Gustawan IW, Wati KDK, Santosa H. Systemic juvenile rheumatic arthritis in 11 years old boy: a case report. Pediatr Indones. 2009;49:119-124.
  3. Schanberg L. Systemic JIA treatment and complications. CARRA. Duke Childrens 2013; -
  4. Pignatti P, Vivarelli M, Meazza C, Rizzolo MG, Martini A, Benedetti FD. Abnormal regulations of interleukin 6 in systemic juvenile idiopathic arthritis. J Rheum. 2001;28:1670-1676
  5. Silva CAA, Silva CHM, Robazzi TC, Lotito APN, Junior AM, Jacob CMA et al. Macrophage activation syndrome associated with systemic juvenile idiopathic arthritis. J 2004;80:517-522.
  6. Grewal DS, Schneider R, Bayer N, Feldman BM. Predictors of disease course and remission in systemic juvenile idiopathic arthritis, significance of early clinical and laboratory features. 2006;54:1596-1601.
  7. Grewal DS, Schneider R, Bayer N, Feldman BM. Predictors of disease course and remission in systemic juvenile idiopathic arthritis, significance of early clinical and laboratory features. 2006;54:1596-1601.
  8. Weiss PF, Klink AJ, Faerber J, Feudtner C. The pediatric rheumatology quality of life scale: validation of the English version in a US cohort of juvenile idiopathic arthritis. Pediatr Rheumatol. 2013;11:1-8
  9. Ilowite NT. Current treatment of juvenile Rheumatoid arthritis. Pediatrics 2002;109:109-115
  10. Gartlehner G, Hansen RA, Jonas BL, Thieda P, Lohr KN. Biologics for the treatment of juvenile idiopathic arthritis: a systematic review and critical analysis of the evidence. Clin Rheumatol. 2008;27:67-76.
  11. Pascual V, Allantaz F, Arce E, Punaro M, Banchereau J. Role of interleukin-1 (IL-1) in the pathogenesis of systemic onset juvenile idiopathic arthritis and clinical response to IL-1 blockade. J Exp Med. 2005;25:1479-1486
  12. Caiello, I, Minnone G, Holzinger D, Vogi T, Prencipe G, Manzo A, et al. IL-6 Amplifies TLR Mediated Cytokine and chemokine productin: implications for the pathogenesis of rheumatic inflammatory diseases. PLOSone. 2014,9:1-106-
  13. Berrada K, Abourazzak FE, Mezouar IE, Lazrak F, Arado N, Tahiri L, et al. A Successful treatment of juvenile idiopathic arthritis with rituximab: A report of two cases. Eur j rheumatol. 2014;49:164-186
  14. Narvaez J, Torne C, Juanola X, Geli C, Llobet JM, Nolla JM, et al. Rituximab therapy for refractory systemic-onset juvenile idiopathic arthritis. Ann Rheum Dis. 2009;68:607-608
  15. Alexeeva EI, Valleva SI, Bzarova TM, Semikina EL, Isaeva KB, Lisitsyn AO et al. Efficacy and safety of repeat courses of rituximab treatment in patients with severe refractory juvenile idiopathic arthritis. Clin Rheumatol. 2011;30:1163-1172.
  16. Edwards JCW, Sczepinski L, Szechinski J, Sosnowska AF, Emery P, Close DR et al. Efficacy of B-Cell-Targeted Therapy with Rituximab in patients with rheumatoid arthritis. N Engl J Med. 2004;25:2572-2581
  17. Ruperto N, Quartier P, Wulffraat N, Woo P, Ravelli A, Mouy R, et al. A Phase II, Multicenter, open-label study evaluating dosage and preliminary safety and efficacy of canakinumab in systemic juvenile idiopathic arthritis with active systemic features. 2012;64:557-567.
  18. Fabrizio De Benedetti, Hermine I Brunner, Nicolino Ruperto, Andrew Kenwright, Stephen Wright, Immaculada Calvo et al. Randomized trial of tocilizumab in systemic juvenile idiopathic arthritis. The New England Journal of Medicine. 2012;365(25) 2385-1395
  19. Yokota S, Itoh Y, Morio T, Origasa H, Sumimoto N, Tomobe M et al. Tocilizumab in systemic juvenile idiopathic arthritis in a real-world clinical setting: results from 1 year of postmarketing surveillance follow-up of 417 patients in Japan. Ann Rheum Dis. 2015;75:1-7
  20. Benedetti F, Brunner H, Ruperto N, Schneider R, Xavier R, Allen R et al. Catch-Up Growth during Tocilizumab Therapy for Systemic Juvenile Idiopathic Arthritis. Arthritis & Rheumatology 2015; 67:840-8
  21. Choy E, Ganeshalingam K, Semb AG, Szekanecz Z, Nurmohamed M. Cardiovascular risk in rheumatoid arthritis: recent advances in the understanding of the pivotal role of inflammation, risk predictors ad the impact of treatment. Rheumatology 2014;53:1-12
  22. Jednacz E, Rutkowska-Sak L. Atherosclerosis in Juvenile Idiopathic Arthritis. Paeditrics Clinic of Rheumatology. 2012;12:1-5

How to Cite

Mayasari, N. M. C., Kumara Wati, K. D., & Santosa, H. (2018). Interleukin-6 receptor antagonist use in systemic juvenile idiopathic arthritis: a case report. Medicina, 49(2). https://doi.org/10.15562/medicina.v49i2.175

HTML
45

Total
35

Share

Search Panel

Ni Made Chandra Mayasari
Google Scholar
Pubmed
Medicina Journal


Ketut Dewi Kumara Wati
Google Scholar
Pubmed
Medicina Journal


Hendra Santosa
Google Scholar
Pubmed
Medicina Journal