Antisynthetase syndrome treated with tocilizumab

Beaumel, A.; Muis-Pistor, Olivier; Tebib, J.; Coury, Fabienne

doi:10.1016/j.jbspin.2015.03.016

Cited by 13 publications

(3 citation statements)

References 10 publications

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“…TCZ has been widely used in the treatment of various refractory autoimmune disorders, such as giant cell arteritis and rheumatoid arthritis ( Smolen et al, 2008 ; Stone et al, 2017 ). Three previous case reports have suggested that IL-6 blockade is effective in IIM ( Narazaki et al, 2011 ; Kondo et al, 2014 ; Beaumel et al, 2016 ). In this prospective study, we demonstrated that an IL-6R antagonist was effective in the clinical improvement of patients with refractory IMNM.…”

Section: Discussionmentioning

confidence: 98%

The Efficacy of Tocilizumab in the Treatment of Patients with Refractory Immune-Mediated Necrotizing Myopathies: An Open-Label Pilot Study

Jiang

et al. 2021

Front. Pharmacol.

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Objective: To evaluate the efficacy of tocilizumab (TCZ) in adult patients with refractory immune-mediated necrotizing myopathies (IMNMs) and investigate possible predictive biomarkers of the response to treatment with TCZ.Methods: Patients with refractory IMNM were enrolled in this open-label pilot observational study and received intravenous TCZ treatment. The clinical response was assessed after 6 months of TCZ treatment according to the 2016 American College of Rheumatology–European League Against Rheumatism (ACR–EULAR) response criteria for adult dermatomyositis and polymyositis. Muscle biopsies were performed to investigate muscle fiber regeneration by immunohistochemical staining of CD56. Serum levels of interleukin (IL)-6 were measured using a multiplex bead-based flow fluorescent immunoassay. The levels of muscle IL-6 mRNA were detected by real-time polymerase chain reaction.Results: A total of 11 patients with refractory IMNM were enrolled in the study, including 3 anti-3-hydroxy-3-methylglutaryl-CoA reductase- and 8 anti-signal recognition particle-positive patients. Seven (63.6%) of these patients achieved clinically significant responses according to the 2016 ACR–EULAR myositis response criteria. Responders had higher baseline serum IL-6 and muscle IL-6 mRNA levels and percentage of CD56-positive muscle fibers than non-responders. Baseline serum IL-6 levels and the percentage of CD56-positive muscle fibers were positively correlated with total improvement score after 6 months of TCZ treatment. Furthermore, muscle fiber necrosis and muscle fiber size variation decreased in repeated muscle biopsies in five responders.Conclusion: Patients with refractory IMNM may respond to TCZ. Baseline serum IL-6 and muscle IL-6 mRNA levels and the percentage of CD56-positive muscle fibers may predict the response to TCZ treatment in these patients.

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Section: Discussionmentioning

confidence: 98%

The Efficacy of Tocilizumab in the Treatment of Patients with Refractory Immune-Mediated Necrotizing Myopathies: An Open-Label Pilot Study

Jiang

et al. 2021

Front. Pharmacol.

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“…Another study showed the beneficial effect of tocilizumab as a third-line biologic in patients with refractory ASS. 45 , 46 Yet another case-control study using anti-IL-6 suggested that tocilizumab may be used as a salvage therapy for rapidly progressive interstitial lung disease patients refractory to an intensive immunosuppressive regimen. 47 …”

Section: Tocilizumab Use In Iimmentioning

confidence: 99%

Biological Therapies in Inflammatory Myopathies

Natour¹,

Kivity²

2023

Rambam Maimonides Med J

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Idiopathic inflammatory myopathies (IIM) are a rare group of disorders that feature progressive immune-mediated skeletal muscle destruction along with skin, lung, and joint involvement. Management of IIMs necessitates glucocorticoid therapy followed by conventional steroid-sparing agents to control disease activity. In the settings of refractory myositis or life-threatening manifestations, e.g. lung involvement or oropharyngeal dysphagia, second-line therapies are needed to minimize disease burden, avoid end-organ damage and steroid toxicity, and decrease mortality. These therapies may include biological disease-modifying antirheumatic drugs (bDMARDs), and to a lesser extent, targeted synthetic disease-modifying antirheumatic drugs (TSD). This article reviews the current use of bDMARDs, e.g. intravenous immunoglobulin and rituximab, and a TSD—Janus kinase inhibitors (JAKI)—along with their indications, efficacy, and safety in managing IIM.

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“… 15 Finally, two case reports from France and the UK demonstrated some value on joint and muscle involvement in patients with anti-Jo-1 myositis. 16 17 …”

Section: Introductionmentioning

confidence: 99%

Long-lasting improvement of refractory antisynthetase syndrome with tocilizumab: a report of two cases

Baumann Benvenuti,

Dudler

2023

RMD Open

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No standardised and universal treatment is available for antisynthetase syndrome. In particular, there is an unmet need for a single efficient treatment acting on its various manifestations, including interstitial lung disease, myositis and polyarthritis.We describe the cases of two patients with multiple and severe manifestations, including joint, muscular and lung involvement, both refractory to various treatments, including rituximab, who demonstrated significant improvement of all their manifestations, including joint, muscular and lung diseases on tocilizumab. The response was also long-lasting, with both patients still being in full remission after >10 years of treatment.Our experience shows that interleukin-6 inhibition could be a very effective treatment option in antisynthetase syndrome, with efficacy on a wide spectrum of manifestations.

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Antisynthetase syndrome treated with tocilizumab

Cited by 13 publications

References 10 publications

The Efficacy of Tocilizumab in the Treatment of Patients with Refractory Immune-Mediated Necrotizing Myopathies: An Open-Label Pilot Study

The Efficacy of Tocilizumab in the Treatment of Patients with Refractory Immune-Mediated Necrotizing Myopathies: An Open-Label Pilot Study

Biological Therapies in Inflammatory Myopathies

Long-lasting improvement of refractory antisynthetase syndrome with tocilizumab: a report of two cases

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