Vasculitis like Horton's disease, some autoinflammatory syndromes (Behcet's, Still's diseases) often require long term treatment with steroids, and therefore are associated with non acceptable adverse events, especially when resistant to treatment. Recently, a number of controlled prospective clinical trials are supporting the interest of the anti-IL-6 receptor monoclonal antibody tocilizumab in these chronic inflammatory conditions et may soon be recognized as second intention therapeutic approach.