Psoriatic arthritis in two patients with an inadequate response to treatment with tocilizumab.

Abstract

Psoriatic arthritis (PsA) is considered as one of the seronegative spondylarthropathies. Like rheumatoid arthritis (RA), the increased production of interleukin (IL)-6 suggests a pathogenic role of IL-6 in PsA. However, whether humanized anti-IL-6 receptor antibody such as tocilizumab (TCZ) might be effective for PsA as well as RA has yet to be determined. We report herein two cases of PsA treated using TCZ. Although, TCZ treatment resulted in disappearance of serum CRP in both patients, arthritis and skin lesions were not improved despite 6-month administration of TCZ. In contrast, tumor necrosis factor (TNF) inhibitor proved effective against arthritis and skin lesions in these patients. Collectively, these findings not only indicate that IL-6 has distinct pathological roles in RA and PsA, but also suggest that TNF inhibitor therapy (but not TCZ) is effective for arthritis and skin lesions of PsA.

• Authors: Atsushi Ogata, Noriko Umegaki, Ichiro Katayama, Atsushi Kumanogoh, Toshio Tanaka
• Journal: Joint bone spine (Joint Bone Spine) Vol. 79 Issue 1 Pg. 85-7 (Jan 2012) ISSN: 1778-7254 [Electronic] France
• PMID: 21962389 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Antibodies, Monoclonal, Humanized
• Interleukin-6
• Tumor Necrosis Factor-alpha
• Adalimumab
• tocilizumab

Topics

• Adalimumab
• Adult
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Arthritis, Psoriatic (drug therapy, metabolism, pathology)
• Drug Substitution
• Humans
• Interleukin-6 (metabolism)
• Male
• Treatment Failure
• Treatment Outcome
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)