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disease, article, stills, google, scholar, pubmed, adultonset, cas, tocilizumab, chen, rheumatol, patients, treatment, clinical, refractory, arthritis, study, clin, taichung, data, taiwan, analysis, httpsdoiorg, aosd, interleukin, response, hsieh, activity, therapy, adult, httpsdoiorgs, medicine, rheumatology, therapeutic, tang, deryuan, systemic, tcz, efficacy, retrospective, access, syndrome, rheum, mod, university, privacy, cookies, content, information, treating,

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month download article/chapter multiple drug-resistant adult-onset der-yuan chen traditional therapy-resistant adult-onset c-wh contributed equally yi-ming chen gov/protocoldevelopment/electronic_applications/ctc hsin-hua chen conventional treatment-refractory adult-onset strobe-compliant article shih-hsin chang single-center observational study chia-wei hsieh treating refractory adult-onset full article pdf privacy choices/manage cookies national cancer institute china medical university jung jy macrophage activation syndrome macrophage-activation syndrome article tang initial conventional treatments high-dose corticosteroids serum cytokine profiles single centre experience lan jl gonzalez-gay ma systemic activity score systemic activity scores yoo dh single-center study multicentre retrospective study van leeuwen ma multicenter retrospective analysis european economic area po-hao huang international task force shiow-jiuan wey biostatistics task force ethics declarations disclosures predict poor response additional information publisher' arthritis care res refractory adult onset refractory adult-onset large multicenter cohort van riel pl medical research conditions privacy policy

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         headline:The effectiveness of tocilizumab in treating refractory adult-onset Still’s disease with dichotomous phenotypes: IL-18 is a potential predictor of therapeutic response
         description:Adult-onset Still’s disease (AOSD) is a systemic inflammatory disorder with clinical heterogeneity. Although tocilizumab (TCZ), an interleukin (IL)-6 receptor inhibitor, is an effective treatment for AOSD, the evidence regarding its efficacy on systemic or articular subtypes is conflicting. Furthermore, the predictors of therapeutic response are still elusive and worthy of exploration. This two-center retrospective study analyzed the effectiveness and safety profile of TCZ treatment in 28 patients with refractory AOSD. The 28-joint disease activity score (DAS28) and systemic activity score were assessed before and during TCZ treatment period at weeks 12, 24, 36, and 48. Plasma levels of proinflammatory cytokines at baseline were determined using ELISA method. Among the systemic subtype patients, 10 (58.8%), 13 (76.5%), 14 (82.4%), and 15 (88.2%) patients achieved complete remission at week 12, 24, 36, and 48, respectively, in comparison to 2 (22.2%), 5 (55.6%), 6 (66.7%), and 7 (77.8%) who achieved disease remission (DAS28 < 2.6) at weeks 12, 24, 36, and 48, respectively, among articular subtype patients. The systemic activity scores and inflammatory parameters were significantly decreased after 12-week TCZ therapy, and TCZ could significantly reduce corticosteroid dose in AOSD patients. Multivariate analysis reveals that baseline IL-18 level is a significant predictor of poor therapeutic response at week 24 (odds ratio 7.86, p < 0.05). AOSD patients refractory to high-dose corticosteroids and methotrexate may respond well to TCZ treatment with a steroid-sparing effect and an acceptable safety. A high baseline IL-18 level may be a predictor of poor therapeutic response.
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      headline:The effectiveness of tocilizumab in treating refractory adult-onset Still’s disease with dichotomous phenotypes: IL-18 is a potential predictor of therapeutic response
      description:Adult-onset Still’s disease (AOSD) is a systemic inflammatory disorder with clinical heterogeneity. Although tocilizumab (TCZ), an interleukin (IL)-6 receptor inhibitor, is an effective treatment for AOSD, the evidence regarding its efficacy on systemic or articular subtypes is conflicting. Furthermore, the predictors of therapeutic response are still elusive and worthy of exploration. This two-center retrospective study analyzed the effectiveness and safety profile of TCZ treatment in 28 patients with refractory AOSD. The 28-joint disease activity score (DAS28) and systemic activity score were assessed before and during TCZ treatment period at weeks 12, 24, 36, and 48. Plasma levels of proinflammatory cytokines at baseline were determined using ELISA method. Among the systemic subtype patients, 10 (58.8%), 13 (76.5%), 14 (82.4%), and 15 (88.2%) patients achieved complete remission at week 12, 24, 36, and 48, respectively, in comparison to 2 (22.2%), 5 (55.6%), 6 (66.7%), and 7 (77.8%) who achieved disease remission (DAS28 < 2.6) at weeks 12, 24, 36, and 48, respectively, among articular subtype patients. The systemic activity scores and inflammatory parameters were significantly decreased after 12-week TCZ therapy, and TCZ could significantly reduce corticosteroid dose in AOSD patients. Multivariate analysis reveals that baseline IL-18 level is a significant predictor of poor therapeutic response at week 24 (odds ratio 7.86, p < 0.05). AOSD patients refractory to high-dose corticosteroids and methotrexate may respond well to TCZ treatment with a steroid-sparing effect and an acceptable safety. A high baseline IL-18 level may be a predictor of poor therapeutic response.
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            name:Taichung Veterans General Hospital
            address:
               name:Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
               type:PostalAddress
            type:Organization
            name:Tunghai University
            address:
               name:Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
               type:PostalAddress
            type:Organization
      name:Yi-Ming Chen
      affiliation:
            name:National Chung Hsing University
            address:
               name:Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
               type:PostalAddress
            type:Organization
            name:Taichung Veterans General Hospital
            address:
               name:Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan
               type:PostalAddress
            type:Organization
            name:National Yang Ming University
            address:
               name:Faculty of Medicine, National Yang Ming University, Taipei, Taiwan
               type:PostalAddress
            type:Organization
            name:Taichung Veterans General Hospital
            address:
               name:Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
               type:PostalAddress
            type:Organization
      name:Shih-Hsin Chang
      affiliation:
            name:National Chung Hsing University
            address:
               name:Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
               type:PostalAddress
            type:Organization
            name:China Medical University Hospital
            address:
               name:Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
               type:PostalAddress
            type:Organization
            name:China Medical University
            address:
               name:College of Medicine, China Medical University, Taichung, Taiwan
               type:PostalAddress
            type:Organization
      name:Po-Hao Huang
      affiliation:
            name:China Medical University Hospital
            address:
               name:Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
               type:PostalAddress
            type:Organization
            name:China Medical University
            address:
               name:College of Medicine, China Medical University, Taichung, Taiwan
               type:PostalAddress
            type:Organization
      name:Joung-Liang Lan
      affiliation:
            name:China Medical University Hospital
            address:
               name:Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
               type:PostalAddress
            type:Organization
            name:China Medical University
            address:
               name:College of Medicine, China Medical University, Taichung, Taiwan
               type:PostalAddress
            type:Organization
      name:Der-Yuan Chen
      url:http://orcid.org/0000-0003-1266-1423
      affiliation:
            name:National Chung Hsing University
            address:
               name:Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
               type:PostalAddress
            type:Organization
            name:China Medical University Hospital
            address:
               name:Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
               type:PostalAddress
            type:Organization
            name:China Medical University
            address:
               name:College of Medicine, China Medical University, Taichung, Taiwan
               type:PostalAddress
            type:Organization
            name:Translational Medicine Laboratory, Rheumatology and Immunology Center
            address:
               name:Translational Medicine Laboratory, Rheumatology and Immunology Center, Taichung, Taiwan
               type:PostalAddress
            type:Organization
      email:[email protected]
PostalAddress:
      name:Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
      name:Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan
      name:Faculty of Medicine, National Yang Ming University, Taipei, Taiwan
      name:Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
      name:Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan
      name:Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
      name:Faculty of Medicine, National Yang Ming University, Taipei, Taiwan
      name:Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
      name:Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
      name:Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
      name:Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan
      name:Faculty of Medicine, National Yang Ming University, Taipei, Taiwan
      name:Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
      name:Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
      name:Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
      name:College of Medicine, China Medical University, Taichung, Taiwan
      name:Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
      name:College of Medicine, China Medical University, Taichung, Taiwan
      name:Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
      name:College of Medicine, China Medical University, Taichung, Taiwan
      name:Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
      name:Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
      name:College of Medicine, China Medical University, Taichung, Taiwan
      name:Translational Medicine Laboratory, Rheumatology and Immunology Center, Taichung, Taiwan
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