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Treatment of polyarteritis nodosa with tocilizumab: a new therapeutic approach?

We describe the effect of interleukin 6 (IL-6) blockade using tocilizumab (TCZ) for inducing and maintaining remission of refractory polyarteritis nodosa (PAN). Three patients with refractory PAN defined according to the American College of Rheumatology criteria were treated with TCZ infusions (8 mg...

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Autores principales: Saunier, Aurélie, Issa, Nahéma, Vandenhende, Marie-Anne, Morlat, Philippe, Doutre, Marie-Sylvie, Bonnet, Fabrice
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574418/
https://www.ncbi.nlm.nih.gov/pubmed/28879047
http://dx.doi.org/10.1136/rmdopen-2017-000446
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author Saunier, Aurélie
Issa, Nahéma
Vandenhende, Marie-Anne
Morlat, Philippe
Doutre, Marie-Sylvie
Bonnet, Fabrice
author_facet Saunier, Aurélie
Issa, Nahéma
Vandenhende, Marie-Anne
Morlat, Philippe
Doutre, Marie-Sylvie
Bonnet, Fabrice
author_sort Saunier, Aurélie
collection PubMed
description We describe the effect of interleukin 6 (IL-6) blockade using tocilizumab (TCZ) for inducing and maintaining remission of refractory polyarteritis nodosa (PAN). Three patients with refractory PAN defined according to the American College of Rheumatology criteria were treated with TCZ infusions (8 mg/kg) on a monthly basis. All of them had severe cutaneous and articular involvement with elevated biological inflammatory markers. One suffered from a neuritis multiplex and one from renal and digestive damage. All three patients were dependent on high doses of glucocorticoids (above 0.5 mg/kg) and two of them were resistant to immunosuppressive drugs. All patients achieved and maintained clinical response and normalisation of the inflammation acute-phase proteins after a few weeks of treatment with TCZ. Prednisolone could be reduced by an average of 41–13 mg/day. These first case reports suggest that IL-6 blockade using TCZ could be a therapeutic alternative to induce remission in patients with polyarteritis nodosa resistant or intolerant to the reference treatment.
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spelling pubmed-55744182017-09-06 Treatment of polyarteritis nodosa with tocilizumab: a new therapeutic approach? Saunier, Aurélie Issa, Nahéma Vandenhende, Marie-Anne Morlat, Philippe Doutre, Marie-Sylvie Bonnet, Fabrice RMD Open Vasculitis We describe the effect of interleukin 6 (IL-6) blockade using tocilizumab (TCZ) for inducing and maintaining remission of refractory polyarteritis nodosa (PAN). Three patients with refractory PAN defined according to the American College of Rheumatology criteria were treated with TCZ infusions (8 mg/kg) on a monthly basis. All of them had severe cutaneous and articular involvement with elevated biological inflammatory markers. One suffered from a neuritis multiplex and one from renal and digestive damage. All three patients were dependent on high doses of glucocorticoids (above 0.5 mg/kg) and two of them were resistant to immunosuppressive drugs. All patients achieved and maintained clinical response and normalisation of the inflammation acute-phase proteins after a few weeks of treatment with TCZ. Prednisolone could be reduced by an average of 41–13 mg/day. These first case reports suggest that IL-6 blockade using TCZ could be a therapeutic alternative to induce remission in patients with polyarteritis nodosa resistant or intolerant to the reference treatment. BMJ Publishing Group 2017-06-29 /pmc/articles/PMC5574418/ /pubmed/28879047 http://dx.doi.org/10.1136/rmdopen-2017-000446 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Vasculitis
Saunier, Aurélie
Issa, Nahéma
Vandenhende, Marie-Anne
Morlat, Philippe
Doutre, Marie-Sylvie
Bonnet, Fabrice
Treatment of polyarteritis nodosa with tocilizumab: a new therapeutic approach?
title Treatment of polyarteritis nodosa with tocilizumab: a new therapeutic approach?
title_full Treatment of polyarteritis nodosa with tocilizumab: a new therapeutic approach?
title_fullStr Treatment of polyarteritis nodosa with tocilizumab: a new therapeutic approach?
title_full_unstemmed Treatment of polyarteritis nodosa with tocilizumab: a new therapeutic approach?
title_short Treatment of polyarteritis nodosa with tocilizumab: a new therapeutic approach?
title_sort treatment of polyarteritis nodosa with tocilizumab: a new therapeutic approach?
topic Vasculitis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574418/
https://www.ncbi.nlm.nih.gov/pubmed/28879047
http://dx.doi.org/10.1136/rmdopen-2017-000446
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