Successful Use of Tocilizumab in a Patient with Coexisting Rheumatoid Arthritis and Ulcerative Colitis
Tocilizumab is an interleukin-6 receptor inhibitor licensed for moderate to severe rheumatoid arthritis (RA). We report a case of Tocilizumab monotherapy for severe active RA in a patient with coexisting ulcerative colitis (UC). The patient was intolerant to multiple disease-modifying drugs, so Toci...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Immunology |
| Online Access: | http://dx.doi.org/10.1155/2016/7562123 |
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| author | Matthew Chak Hin Szeto Metin Devrim Yalçın Abdul Khan Andrzej Piotrowicz |
| author_facet | Matthew Chak Hin Szeto Metin Devrim Yalçın Abdul Khan Andrzej Piotrowicz |
| author_sort | Matthew Chak Hin Szeto |
| collection | DOAJ |
| description | Tocilizumab is an interleukin-6 receptor inhibitor licensed for moderate to severe rheumatoid arthritis (RA). We report a case of Tocilizumab monotherapy for severe active RA in a patient with coexisting ulcerative colitis (UC). The patient was intolerant to multiple disease-modifying drugs, so Tocilizumab monotherapy was commenced. We found clinical improvement in both RA and UC. There was no major adverse event after 2 years. Manufacturer advised caution in using Tocilizumab in patient with gastrointestinal ulceration due to an increased risk of bowel perforation. However, alternative treatments such as glucocorticoid and nonsteroidal anti-inflammatory drugs may carry a higher bowel perforation risk. The presence of gastrointestinal ulceration therefore should not constitute an absolute contraindication for Tocilizumab therapy. Future studies of registry data will inform clinician of the Tocilizumab-related risk of gastrointestinal toxicity in “real-life” settings. Contrary to previous case report, we found Tocilizumab therapy to have a positive effect on UC. Laboratory studies supported a role for interleukin-6 in the pathophysiology of UC. Further clinical trial to evaluate the therapeutic role of Tocilizumab in UC would be warranted. |
| format | Article |
| id | doaj-art-801333be3abb4db5bf056bf344cc9840 |
| institution | OA Journals |
| issn | 2090-6609 2090-6617 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Immunology |
| spelling | doaj-art-801333be3abb4db5bf056bf344cc98402025-08-20T02:08:38ZengWileyCase Reports in Immunology2090-66092090-66172016-01-01201610.1155/2016/75621237562123Successful Use of Tocilizumab in a Patient with Coexisting Rheumatoid Arthritis and Ulcerative ColitisMatthew Chak Hin Szeto0Metin Devrim Yalçın1Abdul Khan2Andrzej Piotrowicz3Queen Elizabeth the Queen Mother Hospital, Margate, UKQueen Elizabeth the Queen Mother Hospital, Margate, UKQueen Elizabeth the Queen Mother Hospital, Margate, UKQueen Elizabeth the Queen Mother Hospital, Margate, UKTocilizumab is an interleukin-6 receptor inhibitor licensed for moderate to severe rheumatoid arthritis (RA). We report a case of Tocilizumab monotherapy for severe active RA in a patient with coexisting ulcerative colitis (UC). The patient was intolerant to multiple disease-modifying drugs, so Tocilizumab monotherapy was commenced. We found clinical improvement in both RA and UC. There was no major adverse event after 2 years. Manufacturer advised caution in using Tocilizumab in patient with gastrointestinal ulceration due to an increased risk of bowel perforation. However, alternative treatments such as glucocorticoid and nonsteroidal anti-inflammatory drugs may carry a higher bowel perforation risk. The presence of gastrointestinal ulceration therefore should not constitute an absolute contraindication for Tocilizumab therapy. Future studies of registry data will inform clinician of the Tocilizumab-related risk of gastrointestinal toxicity in “real-life” settings. Contrary to previous case report, we found Tocilizumab therapy to have a positive effect on UC. Laboratory studies supported a role for interleukin-6 in the pathophysiology of UC. Further clinical trial to evaluate the therapeutic role of Tocilizumab in UC would be warranted.http://dx.doi.org/10.1155/2016/7562123 |
| spellingShingle | Matthew Chak Hin Szeto Metin Devrim Yalçın Abdul Khan Andrzej Piotrowicz Successful Use of Tocilizumab in a Patient with Coexisting Rheumatoid Arthritis and Ulcerative Colitis Case Reports in Immunology |
| title | Successful Use of Tocilizumab in a Patient with Coexisting Rheumatoid Arthritis and Ulcerative Colitis |
| title_full | Successful Use of Tocilizumab in a Patient with Coexisting Rheumatoid Arthritis and Ulcerative Colitis |
| title_fullStr | Successful Use of Tocilizumab in a Patient with Coexisting Rheumatoid Arthritis and Ulcerative Colitis |
| title_full_unstemmed | Successful Use of Tocilizumab in a Patient with Coexisting Rheumatoid Arthritis and Ulcerative Colitis |
| title_short | Successful Use of Tocilizumab in a Patient with Coexisting Rheumatoid Arthritis and Ulcerative Colitis |
| title_sort | successful use of tocilizumab in a patient with coexisting rheumatoid arthritis and ulcerative colitis |
| url | http://dx.doi.org/10.1155/2016/7562123 |
| work_keys_str_mv | AT matthewchakhinszeto successfuluseoftocilizumabinapatientwithcoexistingrheumatoidarthritisandulcerativecolitis AT metindevrimyalcın successfuluseoftocilizumabinapatientwithcoexistingrheumatoidarthritisandulcerativecolitis AT abdulkhan successfuluseoftocilizumabinapatientwithcoexistingrheumatoidarthritisandulcerativecolitis AT andrzejpiotrowicz successfuluseoftocilizumabinapatientwithcoexistingrheumatoidarthritisandulcerativecolitis |