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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Answer

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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