TY - JOUR T1 - Neutropenia During Tocilizumab Treatment Is Not Associated With Infection Risk in Systemic or Polyarticular-Course Juvenile Idiopathic Arthritis JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.180795 SP - jrheum.180795 AU - Manuela Pardeo AU - Jianmei Wang AU - Nicolino Ruperto AU - Ekaterina Alexeeva AU - Vyacheslav Chasnyk AU - Rayfel Schneider AU - Gerd Horneff AU - Hans-Iko Huppertz AU - Kirsten Minden AU - Karen Onel AU - Lawrence Zemel AU - Alan Martin AU - Isabelle Koné-Paut AU - Antigoni Siamopoulou-Mavridou AU - Clovis A. Silva AU - Benjamin Porter-Brown AU - Kamal N. Bharucha AU - Hermine I. Brunner AU - Fabrizio De Benedetti Y1 - 2019/03/01 UR - http://www.jrheum.org/content/early/2019/02/25/jrheum.180795.abstract N2 - Objective To determine whether neutropenia is associated with increased risk for infection in patients with systemic juvenile idiopathic arthritis (sJIA) and polyarticular-course juvenile idiopathic arthritis (pcJIA) treated with tocilizumab (TCZ). Methods Data up to week 104 from 2 phase 3 trials of intravenous TCZ in sJIA (n = 112; ClinicalTrials.gov, NCT00642460) and pcJIA (n = 188; ClinicalTrials.gov, NCT00988221) were pooled. Worst Common Toxicity Criteria grade and lowest observed absolute neutrophil count (ANC) were identified for each patient. Associations between patient characteristics and lowest observed ANC were tested using univariate regression analysis. Infection and serious infection rates (per 100 patient-years [PY]) in periods associated with grades 1/2 and 3/4 neutrophil counts were compared with rates associated with normal neutrophil counts. Results ANCs decreased to grade ≥3 in 25.0% and 5.9% of sJIA and pcJIA patients, respectively, and decreases were transient. Young age (p = 0.047) and methotrexate use (p = 0.012) were positively associated with neutropenia in patients with sJIA but not in patients with pcJIA. The rate of serious infections in patients with sJIA (10.9/100 PY; 95% CI, 6.8-16.5) tended to be higher than in patients with pcJIA (5.2/100 PY; 95% CI, 3-8.5). No increase in rates of serious or nonserious infections was observed during periods of neutropenia in either trial. Conclusion Patients with JIA treated with TCZ experienced transient neutropenia that was not associated with an increased number of infections. ER -