Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

Radiological Evaluation of Systemic Juvenile Idiopathic Arthritis Treated with Tocilizumab, An Anti-IL6 Receptor Monoclonal Antibody.

Aoki1,  Chie, Inaba1,  Yutaka, Imagawa2,  Tomoyuki, Miyamae2,  Takako, Mori2,  Masaaki, Saito2,  Tomoyuki, Yokota2,  Shumpei

Yokohama City Unversity, Yokohama, Japan
Yokohama City University, Yokohama, Japan


Recently tocilizumab (an anti-IL6 receptor monoclonal antibody) has shown clinical benefits in the treatment of systemic juvenile idiopathic arthritis (sJIA) patients. We radiologically evaluated the effects of tocilizumab on the joints by using the carpo-metacarpal ratio (Poznanski score) and Larsen score of sJIA patients.


Forty sJIA patients treated with 8mg/kg of tocilizumab every two weeks were enrolled in this study. We examined bilateral hand radiographs in 32 cases to assess the Poznanski score, and radiographs of the large joints, such as the shoulders, elbows, hips, knees and ankles, to assess the Larsen score in 40 cases before and during treatment. Their clinical response was assessed by active joint count and laboratory data.


The mean age at the start of tocilizumab administration was 9.2 years (range: 2.0~18.6 years), and the mean follow-up period was 3.8 years (range: 0.9~8.8 years). The mean active joint count, and WBC, CRP, ESR and MMP-3 values improved significantly from 4.9 to 0.7 joints, from 15400 to 7200/ml, from 5.7 to 0mg/dl, from 40 to 2mm/h, and from 380 to 172ng/ml, respectively. The Poznanski score improved from -0.9 before tocilizumab treatment to -0.6 at the final follow-up; however, the total Larsen score increased from 10.5 to 11.7 during treatment. The Poznanski score improved in 19 cases (48%), but worsened in 12 cases (30%). The total Larsen score improved in 13 cases (33%: improved group), but worsened in 19 cases (48%: worsened group). There was a significant difference between the two groups in MMP-3 levels (53 in the improved group and 226 in the worsened group) at the final follow-up (P<0.05). The Larsen score in weight-bearing joints, especially the hips, increased more than in other joints in the worsened group.


We evaluated radiographs of patients treated with tocilizumab and observed an improvement in Poznanski score; however, the total Larsen score worsened in patients who had high MMP-3 levels.

To cite this abstract, please use the following information:
Aoki, Chie, Inaba, Yutaka, Imagawa, Tomoyuki, Miyamae, Takako, Mori, Masaaki, Saito, Tomoyuki, et al; Radiological Evaluation of Systemic Juvenile Idiopathic Arthritis Treated with Tocilizumab, An Anti-IL6 Receptor Monoclonal Antibody. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2625

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