What is the role of tocilizumab in the treatment of active systemic juvenile idiopathic arthritis (JIA)?

Updated: Jul 25, 2019
  • Author: David D Sherry, MD; Chief Editor: Lawrence K Jung, MD  more...
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The FDA has approved tocilizumab for the treatment of systemic JIA. Clinical trials in children with JIA showed significantly fewer disease flares when treated with tocilizumab compared with placebo (26% vs 48%). Additionally, a higher success rate of steroid reduction/discontinuance was achieved in the tocilizumab group (24%) compared with placebo (3%). [37]

The phase III TENDER study demonstrated that tocilizumab was effective in improving the signs and symptoms of systemic JIA. After 3 months of treatment, 85% of participants who took tocilizumab had a 30% improvement (JIA ACR30+) in the signs and symptoms of systemic JIA and absence of fever, compared with 24% of patients who received placebo.

Further data showed 70% of patients on tocilizumab achieved JIA ACR70+ and 37% achieved JIA ACR90+, compared with 8% and 5% of patients who received placebo, respectively. Additionally, nearly two-thirds of patients in the study were free of rash after 3 months. In this study, the safety profile similar to adults treated with tocilizumab for rheumatoid arthritis. [38]

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