Accelerated subcutaneous nodulosis in patients with rheumatoid arthritis treated with tocilizumab: a case series.
Identifieur interne : 000104 ( PubMed/Curation ); précédent : 000103; suivant : 000105Accelerated subcutaneous nodulosis in patients with rheumatoid arthritis treated with tocilizumab: a case series.
Auteurs : Rossella Talotta [Italie] ; Fabiola Atzeni [Italie] ; Alberto Batticciotto [Italie] ; Maria Chiara Ditto [Italie] ; Maria Chiara Gerardi [Italie] ; Piercarlo Sarzi-Puttini [Italie]Source :
- Journal of medical case reports [ 1752-1947 ] ; 2018.
Descripteurs français
- KwdFr :
- MESH :
- traitement médicamenteux : Nodule rhumatoïde, Polyarthrite rhumatoïde.
- usage thérapeutique : Anticorps monoclonaux humanisés, Antirhumatismaux, Méthotrexate.
- Adulte d'âge moyen, Femelle, Humains, Mâle, Sujet âgé.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Antibodies, Monoclonal, Humanized, Antirheumatic Agents, Methotrexate.
- drug therapy : Arthritis, Rheumatoid, Rheumatoid Nodule.
- Aged, Female, Humans, Male, Middle Aged.
Abstract
Tocilizumab is a monoclonal antibody directed against the interleukin-6 receptor, which is approved for the treatment of moderate-to-severe rheumatoid arthritis. Authors have found that it prevents lung and subcutaneous nodulosis in patients with rheumatoid arthritis but, to the best of our knowledge, there are no data concerning the acceleration of subcutaneous nodulosis during tocilizumab therapy.
DOI: 10.1186/s13256-018-1687-y
PubMed: 29859543
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sort="Talotta, Rossella" uniqKey="Talotta R" first="Rossella" last="Talotta">Rossella Talotta</name><affiliation wicri:level="1"><nlm:affiliation>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan, Italy. talotta1@virgilio.it.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan</wicri:regionArea></affiliation></author><author><name sortKey="Atzeni, Fabiola" sort="Atzeni, Fabiola" uniqKey="Atzeni F" first="Fabiola" last="Atzeni">Fabiola Atzeni</name><affiliation wicri:level="1"><nlm:affiliation>Rheumatology Unit, University of Messina, via Consolare Valeria 1, 98100, Messina, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Rheumatology Unit, University of Messina, via Consolare Valeria 1, 98100, Messina</wicri:regionArea></affiliation></author><author><name sortKey="Batticciotto, Alberto" sort="Batticciotto, Alberto" uniqKey="Batticciotto A" first="Alberto" last="Batticciotto">Alberto Batticciotto</name><affiliation wicri:level="1"><nlm:affiliation>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan</wicri:regionArea></affiliation></author><author><name sortKey="Ditto, Maria Chiara" sort="Ditto, Maria Chiara" uniqKey="Ditto M" first="Maria Chiara" last="Ditto">Maria Chiara Ditto</name><affiliation wicri:level="1"><nlm:affiliation>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan</wicri:regionArea></affiliation></author><author><name sortKey="Gerardi, Maria Chiara" sort="Gerardi, Maria Chiara" uniqKey="Gerardi M" first="Maria Chiara" last="Gerardi">Maria Chiara Gerardi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan</wicri:regionArea></affiliation></author><author><name sortKey="Sarzi Puttini, Piercarlo" sort="Sarzi Puttini, Piercarlo" uniqKey="Sarzi Puttini P" first="Piercarlo" last="Sarzi-Puttini">Piercarlo Sarzi-Puttini</name><affiliation wicri:level="1"><nlm:affiliation>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of medical case reports</title><idno type="eISSN">1752-1947</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antibodies, Monoclonal, Humanized (therapeutic use)</term><term>Antirheumatic Agents (therapeutic use)</term><term>Arthritis, Rheumatoid (drug therapy)</term><term>Female</term><term>Humans</term><term>Male</term><term>Methotrexate (therapeutic use)</term><term>Middle Aged</term><term>Rheumatoid Nodule (drug therapy)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Anticorps monoclonaux humanisés (usage thérapeutique)</term><term>Antirhumatismaux (usage thérapeutique)</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Méthotrexate (usage thérapeutique)</term><term>Nodule rhumatoïde (traitement médicamenteux)</term><term>Polyarthrite rhumatoïde (traitement médicamenteux)</term><term>Sujet âgé</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antibodies, Monoclonal, Humanized</term><term>Antirheumatic Agents</term><term>Methotrexate</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Arthritis, Rheumatoid</term><term>Rheumatoid Nodule</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Nodule rhumatoïde</term><term>Polyarthrite rhumatoïde</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Anticorps monoclonaux humanisés</term><term>Antirhumatismaux</term><term>Méthotrexate</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Sujet âgé</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Tocilizumab is a monoclonal antibody directed against the interleukin-6 receptor, which is approved for the treatment of moderate-to-severe rheumatoid arthritis. Authors have found that it prevents lung and subcutaneous nodulosis in patients with rheumatoid arthritis but, to the best of our knowledge, there are no data concerning the acceleration of subcutaneous nodulosis during tocilizumab therapy.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">29859543</PMID><DateCompleted><Year>2019</Year><Month>05</Month><Day>07</Day></DateCompleted><DateRevised><Year>2019</Year><Month>05</Month><Day>07</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1752-1947</ISSN><JournalIssue CitedMedium="Internet"><Volume>12</Volume><Issue>1</Issue><PubDate><Year>2018</Year><Month>Jun</Month><Day>03</Day></PubDate></JournalIssue><Title>Journal of medical case reports</Title><ISOAbbreviation>J Med Case Rep</ISOAbbreviation></Journal><ArticleTitle>Accelerated subcutaneous nodulosis in patients with rheumatoid arthritis treated with tocilizumab: a case series.</ArticleTitle><Pagination><MedlinePgn>154</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s13256-018-1687-y</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Tocilizumab is a monoclonal antibody directed against the interleukin-6 receptor, which is approved for the treatment of moderate-to-severe rheumatoid arthritis. Authors have found that it prevents lung and subcutaneous nodulosis in patients with rheumatoid arthritis but, to the best of our knowledge, there are no data concerning the acceleration of subcutaneous nodulosis during tocilizumab therapy.</AbstractText><AbstractText Label="CASE PRESENTATION" NlmCategory="METHODS">We report for the first time a small case series of five patients with rheumatoid arthritis: a 46-year-old white woman, a 70-year-old white woman, a 63-year-old white woman, a 69-year-old white man, and a 72-year-old white woman (mean age 64 ± 10.6 years); they experienced worsening subcutaneous nodulosis during treatment with intravenously administered tocilizumab. Four of the five patients were positive for rheumatoid factor and five for anti-citrullinated peptide antibodies. All of the patients had previously been treated with various conventional and biological drugs; at the time of our observation, three were taking methotrexate, two hydroxychloroquine, and four were taking prednisone. Tocilizumab 8 mg/kg was administered intravenously every 4 weeks for a mean of 43.4 ± 32.4 months, and led to good disease control in three cases. All of the patients had a history of subcutaneous nodulosis, which considerably worsened during tocilizumab treatment, with the development of new nodules on their fingers, elbows, or in the inframammary fold, tending to ulcerate. The management of this medical event included discontinuation of methotrexate, the administration of steroids, the addition of hydroxychloroquine or colchicine, the use of antibiotics, and surgery. However, neither pharmacological nor surgical treatment was completely effective, as the nodules tended to recur and increased in number and size.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">To the best of our knowledge, this is the first report describing accelerated subcutaneous nodulosis in a small case series of patients with rheumatoid arthritis treated with tocilizumab.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Talotta</LastName><ForeName>Rossella</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan, Italy. talotta1@virgilio.it.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Atzeni</LastName><ForeName>Fabiola</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Rheumatology Unit, University of Messina, via Consolare Valeria 1, 98100, Messina, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Batticciotto</LastName><ForeName>Alberto</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ditto</LastName><ForeName>Maria Chiara</ForeName><Initials>MC</Initials><AffiliationInfo><Affiliation>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gerardi</LastName><ForeName>Maria Chiara</ForeName><Initials>MC</Initials><AffiliationInfo><Affiliation>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sarzi-Puttini</LastName><ForeName>Piercarlo</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Rheumatology, ASST Fatebenefratelli-Sacco, via GB Grassi n. 74, 20157, Milan, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2018</Year><Month>06</Month><Day>03</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Med Case Rep</MedlineTA><NlmUniqueID>101293382</NlmUniqueID><ISSNLinking>1752-1947</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D061067">Antibodies, Monoclonal, Humanized</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D018501">Antirheumatic Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>I031V2H011</RegistryNumber><NameOfSubstance UI="C502936">tocilizumab</NameOfSubstance></Chemical><Chemical><RegistryNumber>YL5FZ2Y5U1</RegistryNumber><NameOfSubstance UI="D008727">Methotrexate</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D061067" MajorTopicYN="Y">Antibodies, Monoclonal, Humanized</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018501" MajorTopicYN="Y">Antirheumatic Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001172" MajorTopicYN="Y">Arthritis, Rheumatoid</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008727" MajorTopicYN="N">Methotrexate</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012218" MajorTopicYN="Y">Rheumatoid Nodule</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Rheumatic nodulosis</Keyword><Keyword MajorTopicYN="N">Rheumatoid arthritis</Keyword><Keyword 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