Safety of tocilizumab in children with rheumatic immune disease
AIM To analyze the safety of tocilizumab in children with rheumatic immune disease and provide reference for clinical medication.METHODS The medical records of tocilizumab from January 1st,2016 to August 9th,2022 through the medical record system were collected.Retrospective analysis of the adverse events(AE)incidence and influencing factors,distribution,occurrence time,and outcome.RESULTS A total of 53 children treated with tocilizumab were included,48 cases of systemic juvenile idiopathic arthritis,1 case of Sjogren's syndrome,2 cases of autoimmune disease(autoimmune disease),1 case of juvenile idiopathic arthritis(polyarticular type),and 1 case of multiple arteritis.The incidence of AE was 87％(46/53).The main AE were hypertriglyceridemia(60％),liver injury(49％),hypercholesterolemia(30％),hyperbilirubinemia(8％),neutropenia(9％),hypersensitivity(8％).Hypersensitivity was the main AE leading to drug withdrawal.The occurrence of hypercholesterolemia was associated with higher dose,and the occurrence of liver injury was associated with higher age and higher body mass index.Most of AE were mild and could recover to normal without treatment,and continuous medication rate was 96％(44/46).CONCLUSION The incidence of AE related to the use of tocilizumab in children is high.Hypersensitivity reactions may lead to drug withdrawal,and attention should be paid during the medication period.Although most children only suffer from mild liver injury,it is still necessary to be alert to the possibility of severe liver failure.
tocilizumabsafetydyslipidemiaschemical and drug induced liver injuryautoimmune diseaseshypersensitivity
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