Wakabayashi Hiroki, Kino Hitoshi, Kondo Makoto, Yamanaka Keiichi, Hasegawa Masahiro, Sudo Akihiro
1Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507 Japan.
Kino Orthopedic Clinic, 4-1-7 Kikyogaoka, Nabari, Mie 518-0624 Japan.
BMC Rheumatol. 2019 Apr 24;3:15. doi: 10.1186/s41927-019-0063-x. eCollection 2019.
The details of two rheumatoid arthritis (RA) patients with systemic sclerosis (SSc) who were administered tocilizumab, an anti-interleukin-6 receptor antibody, are reported, along with a review of the literature.
Two RA patients with SSc with inadequate responses to disease-modifying antirheumatic drugs (DMARDs) were given tocilizumab 162 mg every 2 weeks for 18 months. RA disease activity was evaluated by the 28-joint disease activity score with erythrocyte sedimentation rate (DAS28-ESR) and the clinical disease activity index (CDAI). The skin condition of SSc was evaluated by pinching the skin according to the modified Rodnan total skin thickness score (mRSS). Softening of the skin and improvements of arthritis and the patient global assessment were observed during tocilizumab treatment, with reduction of not only RA disease activity, but also of the mRSS.
Tocilizumab may be effective in patients with RA and SSc overlap syndrome for which conventional treatment is inadequate. Further research is needed because this report included only two patients.
报告了两名患有系统性硬化症（SSc）的类风湿关节炎（RA）患者接受抗白细胞介素-6受体抗体托珠单抗治疗的详细情况，并对相关文献进行了综述。
两名对改善病情抗风湿药（DMARDs）反应不佳的合并SSc的RA患者，每2周接受162毫克托珠单抗治疗，持续18个月。通过28个关节疾病活动评分加红细胞沉降率（DAS28-ESR）和临床疾病活动指数（CDAI）评估RA疾病活动度。根据改良Rodnan总皮肤厚度评分（mRSS）通过捏皮肤来评估SSc的皮肤状况。在托珠单抗治疗期间观察到皮肤软化、关节炎改善以及患者整体评估改善，不仅RA疾病活动度降低，mRSS也降低。
对于传统治疗效果不佳的RA和SSc重叠综合征患者，托珠单抗可能有效。由于本报告仅包括两名患者，因此需要进一步研究。
