Interleukin-6 receptor antagonist use in systemic juvenile idiopathic arthritis a case report

Systemic onset Juvenile Idiopathic Arthritis (JIA) accounts for approximately 4-15% of JIA, and has the worst prognosis. Treatment option in SJIA is still limited. Interleukin-6 receptor antagonist is the second line therapy, has been used widely in adult rheumatoid arthritis patients, but no report of pediatric population in Indonesia. To report the efficacy of interleukin-6 receptor antagonist-Tocilizumab in difficult to treat-SJIA management. An 11-years old boy was diagnosed with SJIA and treated with Ibuprofen, then switched to high dose pulse steroid therapy, continued by weekly methotrexate for 6 weeks, however flare up color the clinical manifestation. Following ACR Guideline 2013, tocilizumab every 2 weeks was started. After 4 weeks, the MD Global scores reduced from 10.7 to 3, ACR 70 was achieved, no systemic manifestations were found with normal lab result. Tocilizumab shows beneficial effects in SJIA patient