Espinoza Francisco, Jorgensen Christian, Pers Yves-Marie
Clinical immunology and osteoarticular diseases therapeutic unit, Lapeyronie university hospital, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France.
Clinical immunology and osteoarticular diseases therapeutic unit, Lapeyronie university hospital, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France.
Joint Bone Spine. 2015 Dec;82(6):460-1. doi: 10.1016/j.jbspin.2015.02.008. Epub 2015 Jul 7.
A 43-year-old man was diagnosed with an Eosinophilic fasciitis with cutaneous and articular involvement. The patient experienced an early response with high-dose corticosteroids achieving a global remission of disease. Nevertheless, during the steroids tapering phase, he presented a new flare and subsequently developed a corticosteroid refractory disease. The addition of Methotrexate in monotherapy then associated with an anti-tumor necrosis factor agent did not show any additional benefit. Therefore Tocilizumab, a humanized monoclonal antibody against the interleukin-6 receptor, was initiated achieving an immediate response that persists after 36 months of follow-up. The use of this biological agent allows prednisone withdrawal at 3 months and remission of both articular and cutaneous manifestations at 6 months. This report describes for the first time the efficacy of an anti interleukin-6 agent in Eosinophilic fasciitis treatment.
一名43岁男性被诊断为伴有皮肤和关节受累的嗜酸性筋膜炎。患者对大剂量皮质类固醇有早期反应,实现了疾病的整体缓解。然而,在类固醇减量阶段,他出现了新的病情发作,随后发展为皮质类固醇难治性疾病。单药使用甲氨蝶呤并联合抗肿瘤坏死因子药物未显示出任何额外益处。因此,开始使用抗白细胞介素-6受体的人源化单克隆抗体托珠单抗,获得了即时反应,且在36个月的随访后仍持续存在。使用这种生物制剂可在3个月时停用泼尼松,并在6个月时使关节和皮肤表现缓解。本报告首次描述了抗白细胞介素-6药物在嗜酸性筋膜炎治疗中的疗效。