{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T14:33:52Z","timestamp":1768314832499,"version":"3.49.0"},"reference-count":11,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2017,5,16]]},"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:p>We describe the effect of interleukin 6 (IL-6) blockade using tocilizumab (TCZ) for inducing and maintaining remission of refractory polyarteritis nodosa (PAN). Three patients with refractory PAN defined according to the American College of Rheumatology criteria were treated with TCZ infusions (8\u2009mg\/kg) on a monthly basis. All of them had severe cutaneous and articular involvement with elevated biological inflammatory markers. One suffered from a neuritis multiplex and one from renal and digestive damage. All three patients were dependent on high doses of glucocorticoids (above 0.5\u2009mg\/kg) and two of them were resistant to immunosuppressive drugs. All patients achieved and maintained clinical response and normalisation of the inflammation acute-phase proteins after a few weeks of treatment with TCZ. Prednisolone could be reduced by an average of 41\u201313 mg\/day. These first case reports suggest that IL-6 blockade using TCZ could be a therapeutic alternative to induce remission in patients with polyarteritis nodosa resistant or intolerant to the reference treatment.<\/jats:p>","DOI":"10.1136\/rmdopen-2017-000446","type":"journal-article","created":{"date-parts":[[2017,6,29]],"date-time":"2017-06-29T20:10:56Z","timestamp":1498767056000},"page":"e000446","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Treatment of polyarteritis nodosa with tocilizumab: a new therapeutic approach?"],"prefix":"10.1136","volume":"3","author":[{"given":"Aur\u00e9lie","family":"Saunier","sequence":"first","affiliation":[{"name":"Service de M\u00e9decine Interne et Maladies Infectieuses, H\u00f4pital Saint-Andr\u00e9, CHU de Bordeaux, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nah\u00e9ma","family":"Issa","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne et Maladies Infectieuses, H\u00f4pital Saint-Andr\u00e9, CHU de Bordeaux, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Anne","family":"Vandenhende","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne et Maladies Infectieuses, H\u00f4pital Saint-Andr\u00e9, CHU de Bordeaux, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Morlat","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne et Maladies Infectieuses, H\u00f4pital Saint-Andr\u00e9, CHU de Bordeaux, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Sylvie","family":"Doutre","sequence":"additional","affiliation":[{"name":"Service de Dermatologie, H\u00f4pital Saint-Andr\u00e9, CHU de Bordeaux, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrice","family":"Bonnet","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne et Maladies Infectieuses, H\u00f4pital Saint-Andr\u00e9, CHU de Bordeaux, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,6,29]]},"reference":[{"key":"2025090312435433000_3.1.e000446.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2014.01.029"},{"key":"2025090312435433000_3.1.e000446.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2016.02.015"},{"key":"2025090312435433000_3.1.e000446.3","doi-asserted-by":"publisher","DOI":"10.1002\/art.10922"},{"key":"2025090312435433000_3.1.e000446.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2013.10.001"},{"key":"2025090312435433000_3.1.e000446.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00560-2"},{"key":"2025090312435433000_3.1.e000446.6","doi-asserted-by":"publisher","DOI":"10.1536\/ihj.54.405"},{"key":"2025090312435433000_3.1.e000446.7","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014321"},{"key":"2025090312435433000_3.1.e000446.8","doi-asserted-by":"crossref","first-page":"275","DOI":"10.3109\/13506129.2013.838947","article-title":"AA amyloidosis in a polyarteritis nodosa patient treated with tocilizumab","volume":"20","author":"Ho\u010devar","year":"2013","journal-title":"Amyloid"},{"key":"2025090312435433000_3.1.e000446.9","first-page":"1371","article-title":"Refractory polyarteritis nodosa successfully treated with infliximab.","volume":"32","author":"Al-Bishri","year":"2005","journal-title":"J Rheumatol"},{"key":"2025090312435433000_3.1.e000446.10","doi-asserted-by":"publisher","DOI":"10.1097\/01.rhu.0000173225.41933.83"},{"key":"2025090312435433000_3.1.e000446.11","first-page":"1955","article-title":"Leukocytoclastic vasculitis associated with tumor necrosis factor-alpha blocking agents","volume":"31","author":"Mohan","year":"2004","journal-title":"J Rheumatol"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2017-000446","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:44:05Z","timestamp":1756928645000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2017-000446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,6,29]]},"published-print":{"date-parts":[[2017,6]]}},"alternative-id":["10.1136\/rmdopen-2017-000446"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2017-000446","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6]]}}}