Successful Tocilizumab Therapy for Macrophage Activation Syndrome Associated with Adult-Onset Still’s Disease: A Case-Based Review

Table 2

Case reports of biologic-associated macrophage activation syndrome after administration of biologics for the induction treatment of AOSD.

Pt	Reference	Age (years)	Sex	Disease duration of AOSD	Disease manifestations	Therapy before MAS developing (mg)	Biologics caused MAS	Therapy after biologic-associated MAS (mg)	Adverse events after biologics
1	Gianella et al. [17]	20	F	2 months	F-R-A-LEU-L-HSM	Ibuprofen	ETN	Pulse, PSL (100)	MAS, death
2	Kaneko et al. [18]	44	M	<7 months	F-A-R-LEU	PSL (50–30)	ETN	Pulse: twice, PSL (50), PE: twice, IVIG, AZA	MAS
3	Kobayashi et al. [19]	57	F	3 weeks	F-A-R-LEU-S-L-EST	PSL (80)	TCZ	DXP (0.2 mg/kg), CyA (2 mg/kg)	CMV infection, MAS, CDI
4	Banse et al. [20]	49	F	6 years	F-A-R-LEU-S-L	MTX (0.3 mg/kg), IFX, ANK, TCZ	Canakinumab	IVIG, PSL (1.5 mg/kg)	MAS

MAS, macrophage activation syndrome; AOSD, adult-onset Still’s disease; Pt, patient number; F, fever; A, arthritis; R, skin rash; LEU, leukocytosis; S, sore throat; L, lymphadenopathies; HSM, hepatosplenomegaly; EST, elevated serum transaminases; DIC, disseminated intravascular coagulation; PSL, prednisolone; Pulse, methylprednisolone pulse therapy; MTX, methotrexate; IFX, infliximab; ANK, anakinra; TCZ, tocilizumab; CyA, cyclosporine A; PE, plasma exchange; DXP, dexamethasone palmitate; IVIG, intravenous immunoglobulin; AZA, azathioprine; CMV, cytomegalovirus; CDI, Clostridium difficile infection.