Usefulness of Sarilumab in Patients with Rheumatoid Arthritis after Regression of Lymphoproliferative Disorders

Lymphoproliferative disorders (LPDs) are serious complications associated with rheumatoid arthritis (RA) treatment that mostly occur during methotrexate (MTX) treatment. Cessation of MTX may induce regression of LPDs but is often followed by a flare of RA. Here, we describe two patients with RA flar...

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Main Authors: Yoshifumi Tada, Akira Maeyama, Tomonobu Hagio, Mariko Sakai, Akihito Maruyama, Takuaki Yamamoto
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Case Reports in Rheumatology
Online Access:http://dx.doi.org/10.1155/2023/5780733
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author Yoshifumi Tada
Akira Maeyama
Tomonobu Hagio
Mariko Sakai
Akihito Maruyama
Takuaki Yamamoto
author_facet Yoshifumi Tada
Akira Maeyama
Tomonobu Hagio
Mariko Sakai
Akihito Maruyama
Takuaki Yamamoto
author_sort Yoshifumi Tada
collection DOAJ
description Lymphoproliferative disorders (LPDs) are serious complications associated with rheumatoid arthritis (RA) treatment that mostly occur during methotrexate (MTX) treatment. Cessation of MTX may induce regression of LPDs but is often followed by a flare of RA. Here, we describe two patients with RA flares after the discontinuation of MTX due to LPDs and sarilumab was useful for the treatment of RA without a relapse of LPDs. Patient 1 was an 84-year-old woman, who developed an LPD in the pharyngeal region after 7 years of MTX treatment. Discontinuation of MTX induced regression of LPD but RA flared within 6 months. Administration of sarilumab, in addition to salazosulfapyridine and prednisolone, reduced the RA activity without LPD relapse. Patient 2 was a 76-year-old man, who developed LPD in the pharyngeal region after 5 years of MTX treatment. Discontinuation of MTX induced regression of LPD, but soon RA flared. Although treatment with tocilizumab (TCZ) was effective in controlling RA, it flared again after 2 years. TCZ was switched to sarilumab and RA was in remission. LPD did not recur during these periods.
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spelling doaj-art-3b152a295e404c9a9ca5528dabe611cd2025-02-03T00:12:11ZengWileyCase Reports in Rheumatology2090-68972023-01-01202310.1155/2023/5780733Usefulness of Sarilumab in Patients with Rheumatoid Arthritis after Regression of Lymphoproliferative DisordersYoshifumi Tada0Akira Maeyama1Tomonobu Hagio2Mariko Sakai3Akihito Maruyama4Takuaki Yamamoto5Department of RheumatologyDepartment of Orthopaedic SurgeryDepartment of Orthopaedic SurgeryDepartment of RheumatologyDepartment of RheumatologyDepartment of Orthopaedic SurgeryLymphoproliferative disorders (LPDs) are serious complications associated with rheumatoid arthritis (RA) treatment that mostly occur during methotrexate (MTX) treatment. Cessation of MTX may induce regression of LPDs but is often followed by a flare of RA. Here, we describe two patients with RA flares after the discontinuation of MTX due to LPDs and sarilumab was useful for the treatment of RA without a relapse of LPDs. Patient 1 was an 84-year-old woman, who developed an LPD in the pharyngeal region after 7 years of MTX treatment. Discontinuation of MTX induced regression of LPD but RA flared within 6 months. Administration of sarilumab, in addition to salazosulfapyridine and prednisolone, reduced the RA activity without LPD relapse. Patient 2 was a 76-year-old man, who developed LPD in the pharyngeal region after 5 years of MTX treatment. Discontinuation of MTX induced regression of LPD, but soon RA flared. Although treatment with tocilizumab (TCZ) was effective in controlling RA, it flared again after 2 years. TCZ was switched to sarilumab and RA was in remission. LPD did not recur during these periods.http://dx.doi.org/10.1155/2023/5780733
spellingShingle Yoshifumi Tada
Akira Maeyama
Tomonobu Hagio
Mariko Sakai
Akihito Maruyama
Takuaki Yamamoto
Usefulness of Sarilumab in Patients with Rheumatoid Arthritis after Regression of Lymphoproliferative Disorders
Case Reports in Rheumatology
title Usefulness of Sarilumab in Patients with Rheumatoid Arthritis after Regression of Lymphoproliferative Disorders
title_full Usefulness of Sarilumab in Patients with Rheumatoid Arthritis after Regression of Lymphoproliferative Disorders
title_fullStr Usefulness of Sarilumab in Patients with Rheumatoid Arthritis after Regression of Lymphoproliferative Disorders
title_full_unstemmed Usefulness of Sarilumab in Patients with Rheumatoid Arthritis after Regression of Lymphoproliferative Disorders
title_short Usefulness of Sarilumab in Patients with Rheumatoid Arthritis after Regression of Lymphoproliferative Disorders
title_sort usefulness of sarilumab in patients with rheumatoid arthritis after regression of lymphoproliferative disorders
url http://dx.doi.org/10.1155/2023/5780733
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