Tocilizumab in Systemic Juvenile Idiopathic Arthritis: Response Differs by Disease Duration at Medication Initiation and by Phenotype of Disease

Objective: We performed a single-center retrospective study to determine the different efficacy of tocilizumab (TCZ) in the early and late stages and in three phenotypic subgroups (monocyclic, polycyclic, and persistent) of systemic juvenile idiopathic arthritis (sJIA).Methods: Clinical and serologi...

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Autores principales:	Xin Yan, Wenjing Tang, Zhiyong Zhang, Yu Zhang, Chong Luo, Xuemei Tang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	systemic juvenile idiopathic arthritis tocilizumab clinical trial pediatric treatment Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/1120430879074bf395aa0d1116885345
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spelling	oai:doaj.org-article:1120430879074bf395aa0d11168853452021-11-08T07:15:19ZTocilizumab in Systemic Juvenile Idiopathic Arthritis: Response Differs by Disease Duration at Medication Initiation and by Phenotype of Disease2296-236010.3389/fped.2021.735846https://doaj.org/article/1120430879074bf395aa0d11168853452021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fped.2021.735846/fullhttps://doaj.org/toc/2296-2360Objective: We performed a single-center retrospective study to determine the different efficacy of tocilizumab (TCZ) in the early and late stages and in three phenotypic subgroups (monocyclic, polycyclic, and persistent) of systemic juvenile idiopathic arthritis (sJIA).Methods: Clinical and serological parameters of 77 sJIA patients treated by TCZ were collected from November 1, 2013 to May 1, 2019. Patients were grouped based on the duration group A < 6 months (n = 41) and group B > 6 months (n = 36) and divided into three phenotypes: monocyclic (n = 12), polycyclic (n = 14), and persistent (n = 51) course.Results: At baseline, group A had pronounced ESR, fever less active arthritis than group B (p < 0.05). After 12 weeks of therapy, TCZ alleviated fever, ESR, CRP, and systemic-onset juvenile arthritis disease activity score-27 (sJADAS27) in both group A and group B (p>0.05), while the efficacy of TCZ in relieving active arthritis in group A was better than that in group B (p<0.05). After 1 year of TCZ therapy, it showed that patients with monocyclic phenotype had the highest clinical response rate (91.7%, odds ratio = 0, 95% CI: 24–24, p = 0.00), followed by the polycyclic (28.6%, odds ratio = 2.1, 95% CI: 10.5–18.8, p = 0.00) and the persistent course (9.8%, odds ratio = 1.2, 95% CI: 9.5–13.8, p = 0.00).Conclusion: TCZ can quickly relieve fever and inflammation, especially when patients have less active arthritis with shorter disease duration. The long-term efficacy of TCZ is related to the phenotypes, among which the monocyclic is the best, and the persistent is the worst.Xin YanXin YanXin YanWenjing TangWenjing TangWenjing TangZhiyong ZhangZhiyong ZhangZhiyong ZhangYu ZhangYu ZhangYu ZhangChong LuoChong LuoChong LuoXuemei TangXuemei TangXuemei TangFrontiers Media S.A.articlesystemic juvenile idiopathic arthritistocilizumabclinical trialpediatrictreatmentPediatricsRJ1-570ENFrontiers in Pediatrics, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	systemic juvenile idiopathic arthritis tocilizumab clinical trial pediatric treatment Pediatrics RJ1-570
spellingShingle	systemic juvenile idiopathic arthritis tocilizumab clinical trial pediatric treatment Pediatrics RJ1-570 Xin Yan Xin Yan Xin Yan Wenjing Tang Wenjing Tang Wenjing Tang Zhiyong Zhang Zhiyong Zhang Zhiyong Zhang Yu Zhang Yu Zhang Yu Zhang Chong Luo Chong Luo Chong Luo Xuemei Tang Xuemei Tang Xuemei Tang Tocilizumab in Systemic Juvenile Idiopathic Arthritis: Response Differs by Disease Duration at Medication Initiation and by Phenotype of Disease
description	Objective: We performed a single-center retrospective study to determine the different efficacy of tocilizumab (TCZ) in the early and late stages and in three phenotypic subgroups (monocyclic, polycyclic, and persistent) of systemic juvenile idiopathic arthritis (sJIA).Methods: Clinical and serological parameters of 77 sJIA patients treated by TCZ were collected from November 1, 2013 to May 1, 2019. Patients were grouped based on the duration group A < 6 months (n = 41) and group B > 6 months (n = 36) and divided into three phenotypes: monocyclic (n = 12), polycyclic (n = 14), and persistent (n = 51) course.Results: At baseline, group A had pronounced ESR, fever less active arthritis than group B (p < 0.05). After 12 weeks of therapy, TCZ alleviated fever, ESR, CRP, and systemic-onset juvenile arthritis disease activity score-27 (sJADAS27) in both group A and group B (p>0.05), while the efficacy of TCZ in relieving active arthritis in group A was better than that in group B (p<0.05). After 1 year of TCZ therapy, it showed that patients with monocyclic phenotype had the highest clinical response rate (91.7%, odds ratio = 0, 95% CI: 24–24, p = 0.00), followed by the polycyclic (28.6%, odds ratio = 2.1, 95% CI: 10.5–18.8, p = 0.00) and the persistent course (9.8%, odds ratio = 1.2, 95% CI: 9.5–13.8, p = 0.00).Conclusion: TCZ can quickly relieve fever and inflammation, especially when patients have less active arthritis with shorter disease duration. The long-term efficacy of TCZ is related to the phenotypes, among which the monocyclic is the best, and the persistent is the worst.
format	article
author	Xin Yan Xin Yan Xin Yan Wenjing Tang Wenjing Tang Wenjing Tang Zhiyong Zhang Zhiyong Zhang Zhiyong Zhang Yu Zhang Yu Zhang Yu Zhang Chong Luo Chong Luo Chong Luo Xuemei Tang Xuemei Tang Xuemei Tang
author_facet	Xin Yan Xin Yan Xin Yan Wenjing Tang Wenjing Tang Wenjing Tang Zhiyong Zhang Zhiyong Zhang Zhiyong Zhang Yu Zhang Yu Zhang Yu Zhang Chong Luo Chong Luo Chong Luo Xuemei Tang Xuemei Tang Xuemei Tang
author_sort	Xin Yan
title	Tocilizumab in Systemic Juvenile Idiopathic Arthritis: Response Differs by Disease Duration at Medication Initiation and by Phenotype of Disease
title_short	Tocilizumab in Systemic Juvenile Idiopathic Arthritis: Response Differs by Disease Duration at Medication Initiation and by Phenotype of Disease
title_full	Tocilizumab in Systemic Juvenile Idiopathic Arthritis: Response Differs by Disease Duration at Medication Initiation and by Phenotype of Disease
title_fullStr	Tocilizumab in Systemic Juvenile Idiopathic Arthritis: Response Differs by Disease Duration at Medication Initiation and by Phenotype of Disease
title_full_unstemmed	Tocilizumab in Systemic Juvenile Idiopathic Arthritis: Response Differs by Disease Duration at Medication Initiation and by Phenotype of Disease
title_sort	tocilizumab in systemic juvenile idiopathic arthritis: response differs by disease duration at medication initiation and by phenotype of disease
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/1120430879074bf395aa0d1116885345
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Tocilizumab in Systemic Juvenile Idiopathic Arthritis: Response Differs by Disease Duration at Medication Initiation and by Phenotype of Disease

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