Weber E, Gaultier J-B, Paul S, Guichard I, Monard E, Cathébras P
Service de médecine interne, hôpital Nord, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
Laboratoire d'immunologie, hôpital Nord, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
Rev Med Interne. 2014 Mar;35(3):196-8. doi: 10.1016/j.revmed.2013.02.019. Epub 2013 Sep 25.
Relapsing polychondritis (RP) is a rare inflammatory disease characterized by diffuse cartilage involvement, especially those of the respiratory tract, leading to potentially life threatening complications. Corticosteroids remain the first-line empirical therapy. Immunosuppressive drugs such as azathioprine, cyclophosphamide and tumor necrosis factor blockers (anti-TNFα) are commonly used as second-line therapy with varying degrees of success.
We report a 40-year-old man with severe RP for whom conventional therapy and immunosuppressive treatments were ineffective. Prolonged clinical remission was obtained after introduction of the anti-interleukin-6 receptor antibody (tocilizumab), which was perfectly tolerated and allowed to taper steroids and methotrexate to a very low dosage.
Our patient is the fifth published one documenting the efficacy of tocilizumab in severe refractory RP, which strengthens the use of anti-IL-6 in that indication.
复发性多软骨炎(RP)是一种罕见的炎症性疾病,其特征为软骨弥漫性受累,尤其是呼吸道软骨,可导致潜在的危及生命的并发症。糖皮质激素仍然是一线经验性治疗药物。硫唑嘌呤、环磷酰胺等免疫抑制药物以及肿瘤坏死因子阻滞剂(抗TNFα)通常用作二线治疗,取得了不同程度的成功。
我们报告一名40岁患有严重RP的男性,其常规治疗和免疫抑制治疗均无效。引入抗白细胞介素-6受体抗体(托珠单抗)后获得了长期临床缓解,该抗体耐受性良好,使得糖皮质激素和甲氨蝶呤能够减至非常低的剂量。
我们的患者是第五例发表的证明托珠单抗对严重难治性RP有效的病例,这进一步支持了抗IL-6在该适应症中的应用。