Efficacy and safety of tocilizumab in adult-onset Still's disease: a multicenter study from AIDA registry

Link to article DOI: 10.1016/j.semarthrit.2022.152089

Evidence on the long-term efficacy and safety of tocilizumab in adult-onset Still's disease mostly derives from small case series. The present work provides a real-life experience on the effectiveness of tocilizumab in a large cohort of patients with adult-onset Still's disease (AOSD) assessed by clinical and serum inflammatory markers as well as drug retention rate analysis. Data from 31 patients with AOSD, refractory to the conventional therapies and treated with tocilizumab were retrieved. Efficacy was assessed between baseline and last follow-up evaluations in terms of changes in the Pouchot score and laboratory findings. Drug-retention rate was estimated by the Kaplan-Meier method, while Cox-regression analysis was employed to detect potential predictors of treatment withdrawal. Study results show that tocilizumab allows control of disease activity as well as normalization of serum inflammatory markers in both systemic and chronic articular form of AOSD. Furthermore, our data display an excellent drug retention of tocilizumab with an estimated persistence on treatment of 63.7% at 3-year follow-up. Finally, a steroid-sparing effect was observed which considerably reduces the risk of side-effects related to long-term exposure to corticosteroids.