Tocilizumab treatment safety in rheumatoid arthritis in a patient with multiple sclerosis: a case report

BMC Research Notes

Ichiei Narita²  Masaaki Nakano¹  Takeshi Kuroda²  Akira Murasawa³  Kiyoshi Nakazono³  Hajime Ishikawa³  Satoshi Ito³  Asami Abe³  Daisuke Kobayashi³  Hiroe Sato² 

[1] Department of Medical Technology, School of Health Sciences, Faculty of Medicine, Niigata University, 2-746 Asahimachi-Dori, Chuoku, Niigata City 951-8518, Japan;Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuoku, Niigata City, Niigata 951-8510, Japan;Department of Rheumatology, Niigata Rheumatic Center, 1-2-8 Honcho, Shibata City, Niigata 957-0054, Japan

关键词: Tumour necrosis factor;    Interleukin-6;    Tocilizumab;    Multiple sclerosis;    Rheumatoid arthritis;   

Others  :  1129549
DOI  :  10.1186/1756-0500-7-641

 received in 2014-01-30, accepted in 2014-09-02,  发布年份 2014

【 摘 要 】

Background

Multiple sclerosis is a relatively rare disease, and complications of multiple sclerosis and rheumatoid arthritis are much rarer. Since anti-tumor necrosis factor therapy increases exacerbations of multiple sclerosis, complications of demyelinating diseases contraindicate anti-tumor necrosis factor therapy. There have been few reports of anti-interleukin-6 receptor therapy for patients with rheumatoid arthritis complicated with multiple sclerosis.

Case presentation

A 53-year-old Japanese woman with multiple sclerosis and rheumatoid arthritis was admitted to our hospital because her rheumatoid arthritis was uncontrolled with oral methotrexate, tacrolimus, and prednisolone. She had developed multiple sclerosis when she was 25 years old and was treated with glucocorticoid therapy. Her multiple sclerosis was in remission for more than 9 years. Because anti-tumour necrosis factor therapy can exacerbate demyelinating disease, the anti-interleukin-6 receptor antibody tocilizumab was started at 8 mg/kg every 4 weeks. At the second administration of tocilizumab, complete remission was achieved. She has remained in remission with tocilizumab without recurrence of multiple sclerosis for more than 5 years.

Conclusion

Anti-interleukin-6 therapy was safely used in this patient with rheumatoid arthritis without exacerbations of multiple sclerosis.

【 授权许可】

   
2014 Sato et al.; licensee BioMed Central Ltd.

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