Division of Rheumatology, Department of Internal Medicine, Saga University School of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan.
Mod Rheumatol. 2012 Sep;22(5):712-9. doi: 10.1007/s10165-011-0569-6. Epub 2011 Dec 9.
The efficacy of biologics in treating adult Still's disease (ASD) is suggested, but the information is still lacking and the validation is insufficient. To determine the efficacy of several biologic agents in refractory ASD in Japan, a multicenter survey was performed.
Clinical data on 16 ASD patients who had been treated with at least 1 of the biological agents (total 24 occasions) were collected retrospectively.
Infliximab was used in 9 cases, etanercept in 4, and tocilizumab in 11. Half of the patients that had been treated initially with infliximab or etanercept were changed to another biologics. Tocilizumab was effective in cases switched from another 2 drugs. Tocilizumab showed efficacy in treating both systemic and arthritic symptoms and showed apparent steroid-sparing effect and the highest continuation rate.
Tocilizumab may be a promising biologic agent in refractory ASD.
生物制剂治疗成人斯蒂尔病（ASD）的疗效已被证实，但相关信息仍有限，尚需进一步验证。本研究旨在评估生物制剂治疗日本难治性 ASD 的疗效，进行了一项多中心回顾性研究。
收集了至少使用 1 种生物制剂（共 24 次）治疗的 16 例 ASD 患者的临床资料。
9 例患者使用英夫利昔单抗，4 例使用依那西普，11 例使用托珠单抗。最初使用英夫利昔单抗或依那西普治疗的半数患者被换用其他生物制剂。托珠单抗对由其他 2 种药物转换治疗的患者有效。托珠单抗对全身和关节炎症状均有效，具有明显的激素节省作用和最高的持续缓解率。
托珠单抗可能是一种有前途的治疗难治性 ASD 的生物制剂。
