Secondary Failure of Tocilizumab in Treating Elderly-Onset Rheumatoid Arthritis With Systemic Symptoms Complicated by Diverticulum Perforation

The treatment of rheumatoid arthritis (RA) has advanced from the use of steroids to disease-modifying anti-rheumatic drugs (DMARDs) and biologics such as tumor necrosis factor (TNF) and interleukin-6 (IL-6) inhibitors. Historically, steroids have been the mainstream in the clinical treatment of RA;...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-08, Vol.14 (8)
Main Authors: Takagi, Soshi, Naito, Yumi, Sano, Chiaki, Ohta, Ryuichi
Format: Article
Language:English
Subjects:
Abdomen
Allergy/Immunology
Antibodies
Antigens
Biological products
Blood
Case reports
Colon
Diverticulitis
Family/General Practice
Hepatitis C
Infections
Infectious diseases
Kinases
Laboratories
Lupus
Monoclonal antibodies
Otolaryngology
Pain
Patients
Proteins
Rheumatoid arthritis
Rheumatology
Severe acute respiratory syndrome coronavirus 2
Steroids
Tomography
Tuberculosis
Tumor necrosis factor-TNF
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Summary:The treatment of rheumatoid arthritis (RA) has advanced from the use of steroids to disease-modifying anti-rheumatic drugs (DMARDs) and biologics such as tumor necrosis factor (TNF) and interleukin-6 (IL-6) inhibitors. Historically, steroids have been the mainstream in the clinical treatment of RA; however, the development of DMARDs has changed the RA treatment structure. In addition, biologics can alleviate RA symptoms. This case report describes the secondary failure of tocilizumab in treating RA with fatigue symptoms. Treatment with tocilizumab decreases C-reactive protein (CRP) levels, which may make detecting RA exacerbation difficult; therefore, obtaining the patient's precise history and thorough physical examinations are necessary. This case demonstrates the complexity of treating elderly-onset RA and reports practical methods for effective treatment.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.28357