Remission of arthritis but persistent cutaneous lesions following tocilizumab treatment in a RA-patient suffering from concomitant psoriasis

Abstract

Modulation of the interleukin-6 pathway with tocilizumab has been demonstrated to be highly effective in substantial numbers of patients suffering from rheumatoid arthritis (RA), and juvenile idiopathic arthritis. A pivotal role of the IL-6 pathway has been also established in other autoimmune conditions including psoriasis and psoriatic arthritis, becoming attractive targets for therapeutic IL-6 inhibition. Here, we describe the first case of tocilizumab treatment in a RA-patient suffering from concomitant severe psoriasis, who achieved remission of RA, whereas no improvement of psoriatic lesions could be observed.

Share and Cite:

Hartung, W. , Ehrenstein, B. , Wallisch, R. and Fleck, M. (2013) Remission of arthritis but persistent cutaneous lesions following tocilizumab treatment in a RA-patient suffering from concomitant psoriasis. Case Reports in Clinical Medicine, 2, 63-65. doi: 10.4236/crcm.2013.21018.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Nishimoto, N., Yoshizaki, K., Miyasaka, N., Yamamoto, K., Kawai, S., Takeuchi, T., Hashimoto, J., Azuma, J. and Kishimoto, T. (2004) Treatment of rheumatoid arthritis with humanized anti-interleukin-6 receptor antibody: A multicenter, double-blind, placebo-controlled trial. Arthritis & Rheumatism, 50, 1761-1769. doi:10.1002/art.20303
[2] Maini, R.N., Taylor, P.C., Szechinski, J., Pavelka, K., Br?ll, J., Balint, G., Emery, P., Raemen, F., Petersen, J., Smolen, J., Thomson, D. and Kishimoto, T. (2006) Double-blind randomized controlled clinical trial of the interleukin-6 receptor antagonist, tocilizumab, in european patients with rheumatoid arthritis who had an incomplete response to methotrexate. Arthritis & Rheumatism, 54, 2817-2829. doi:10.1002/art.22033
[3] Emery, P., Keystone, E., Tony, H.P., Cantagrel, A., van Vollenhoven, R., Sanchez, A., Alecock, E., Lee, J. and Kremer, J. (2008) Il-6 receptor inhibition with tocilizumab improves treatment outcomes in patients with rheumatoid arthritis refractory to anti-tumour necrosis factor biologicals: Results from a 24-week multicentre randomised placebo-controlled trial. Annals of the Rheumatic Diseases, 67, 1516-1523. doi:10.1136/ard.2008.092932
[4] Genovese, M.C., McKay, J.D., Nasonov, E.L., Mysler, E.F., da Silva, N.A., Alecock, E., Woodworth, T. and Gomez-Reino, J.J. (2008) Interleukin-6 receptor inhibition with tocilizumab reduces disease activity in rheumatoid arthritis with inadequate response to disease-modifying antirheumatic drugs: The tocilizumab in combination with traditional disease-modifying antirheumatic drug therapy study. Arthritis & Rheumatism, 58, 2968-2980. doi:10.1002/art.23940
[5] Jones, G., Sebba, A., Gu, J., Lowenstein, M.B., Calvo, A., Gomez-Reino, J.J., Siri, D.A., Tomsic, M., Alecock, E., Woodworth, T. and Genovese, M.C. (2010) Comparison of tocilizumab monotherapy versus methotrexate monotherapy in patients with moderate to severe rheumatoid arthritis: The ambition study. Annals of the Rheumatic Diseases, 69, 88-96. doi:10.1136/ard.2008.105197
[6] Smolen, J.S., Beaulieu, A., Rubbert-Roth, A., Ramos-Remus, C., Rovensky, J., Alecock, E., Woodworth, T. and Alten, R. (2008) Effect of interleukin-6 receptor inhibition with tocilizumab in patients with rheumatoid arthritis (option study): A double-blind, placebo-controlled, randomised trial. Lancet, 371, 987-997. doi:10.1016/S0140-6736(08)60453-5
[7] Van Kuijk, A.W. and Tak, P.P. (2011) Synovitis in psoriatric arthritis: Immunohistochemistry, comparisons with rheumatoid arthritis, and effects of therapy. Current Rheumatology Reports, 13, 353-369. doi:10.1007/s11926-011-0181-y
[8] Zheng, Y., Danilenko, D.M., Valdez, P., Kasman, I., Eastham-Anderson, J., Wu, J. and Ouyang, W. (2007) Interleukin-22, a t(h)17 cytokine, mediates il-23-induced dermal inflammation and acanthosis. Nature, 445, 648-651. doi:10.1038/nature05505
[9] Annunziato, F., Cosmi, L., Liotta, F., Maggi, E. and Romagnani, S. (2009) Type 17 t helper cells-origins, features and possible roles in rheumatic disease. Nature Reviews Rheumatology, 5, 325-331. doi:10.1038/nrrheum.2009.80

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.