Hemoglobin and C-reactive protein levels as predictive factors for long-term successful glucocorticoid treatment for multicentric Castleman’s disease

Abstract

Although anti-interleukin-6 therapy with tocilizumab and siltuximab is recommended for multicentric Castleman’s disease (MCD), burdens caused by frequent hospital visits and high drug payments is an issue to be considered. Although glucocorticoid monotherapy might be less effective compared to these agents, substantial proportions of patients can be successfully treated for years. Therefore, we conducted a retrospective analysis of Castleman’s disease patients to explore predictors of glucocorticoid responsiveness and revealed that higher hemoglobin and/or lower C-reactive protein levels before starting glucocorticoid monotherapy were associated with lower probability of requirements for second-line treatment among patients initially treated with glucocorticoid. We concluded that glucocorticoids had a potential to induce sustained disease control for indolent MCD patients with specific clinical characteristics.

Keywords:

• Multicentric Castleman’s disease
• prednisolone
• tocilizumab

Author contributions

KE collected and analyzed the data and wrote the manuscript. AS, AH, YM, FN and MK advised the analyses and helped writing the manuscript.

Disclosure statement

Drs K.E., A.S., A.H., Y.M., F.N., declared that we had no relevant financial interests. Dr M.K. has received consulting fee, research funding and speaking fee from Chugai Pharmaceutical Co., Ltd. Dr M.K. has received consulting fee and honoraria from Sionogi Pharma Co., Ltd.

There was no other relevant associations that might reasonably represent or create the perception of a COI related to this work.