Tocilizumab is a recombinant humanized monoclonal antibody that acts as a receptor antagonist for interleukin 6. Both in the United States of America and in Europe, it is approved for the treatment of 2 subtypes of juvenile idiopathic arthritis, systemic juvenile idiopathic arthritis and polyarticular juvenile idiopathic arthritis >= 2 years of age.
This article provides an overview of the use of tocilizumab in the treatment of some forms of juvenile idiopathic arthritis and demonstrates its positive effect on the example of 4 year-old boy with systemic juvenile idiopathic arthritis. Our case report describes the successful therapy with tocilizumab after failure of conventional treatment including non-steroidal anti-inflammatory drugs, systemic corticosteroids and methotrexate.
The disease was under control after two months of tocilizumab initiation. During further 12 months of treatment, the patient reached a clinical remission of the disease.
The introduction of modern treatment options in the form of cytokine inhibitors significantly improved the quality of life and prognosis of patients, particularly with the most severe forms of juvenile idiopathic arthritis. Tocilizumab extends the range of treatment options in patients with juvenile idiopathic arthritis who do not respond adequately to conventional anti-rheumatic disease modifying drugs and tumor necrosis factor inhibitors.