Trial reportRheumatology (Oxford, England)2025
Serum cytokine levels towards precision medicine in Still's disease: a subanalysis of a randomized controlled trial of tocilizumab.
Trial report in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
10 authors.
Funding
Abstract
objectivesTo predict the efficacy of IL-6 inhibition in patients with Still's disease by analysing inflammatory cytokine profiles before and during an IL-6 receptor inhibitor therapy.
methodsThis is a subanalysis of the 52-week, randomized, double-blind, placebo-controlled trial of tocilizumab, an IL-6 receptor inhibitor, in patients with Still's disease. Multiple serum cytokine levels were measured regularly, and their pattern and profiles were analysed based on the response to tocilizumab.
resultsA total of 26 patients (13 in the tocilizumab group and 13 in the placebo group) were enrolled. Before tocilizumab treatment, IL-6 levels were correlated with DAS with 28 joints (r = 0.67, P < 0.01), and IL-1β, IL-6 and IL-18 levels tended to be correlated with systemic feature score (r = 0.33, P = 0.09; r = 0.38, P = 0.05; r = 0.40, P = 0.04, respectively). IL-6 and IL-6 receptor levels were significantly elevated after tocilizumab initiation, while the other cytokines showed no significant difference compared with placebo. Baseline levels of IFN-γ and IL-1β were significantly higher in non-responders compared with responders (28.49 vs 5.65 pg/ml, P = 0.03; 0.26 vs 0.04 pg/ml, P = 0.048), and IFN-γ and IL-18 levels at week 52 remained high in non-responders (15.56 vs 7.03 pg/ml, P = 0.02; 5924 vs 392 pg/ml, P = 0.02).
conclusionsThe effect of tocilizumab is limited to the IL-6 signalling pathway in Still's disease. Patients who did not respond to tocilizumab exhibited distinct cytokine profiles that pivot the IFN-γ axis. These findings highlight the role of IL-6 inhibition in Still's disease and shed light on its personalized treatment strategies. CLINICAL TRIAL REGISTRATION NUMBER: UMIN Clinical Trials Registry; UMIN000012987.
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