Development of rheumatoid arthritis during anti-interleukin- | JAA – Dove Medical Press

¹Departworkment of Respiratory Medicine, College of Occupational and Environmental Well being, Kitakyushu, Fukuoka, 807-8555, Japan; ²Departworkment of Medical Nursing, College of Occupational and Environmental Well being, Kitakyushu, Fukuoka, 807-8555, Japan

Correspondence: Hiroki Kawabata
Departworkment of Respiratory Medicine, College of Occupational and Environmental Well being, 1-1 Iseigaoka, Yahata-nishiku, Kitakyushu, Fukuoka, 807-8555, Japan
Tel +81-93-691-7453
Fax +81-93-602-9373
E-mail [email protected]

Objective: To report the case of a affected person with refractory continuous eosinophilic pneumonia who developed rheumatoid artworkhritis all by way of anti-interleukin (IL)-5 remedy.
Case Report: The case of a 66-yr-previous male ex-smoker with allergic rhinitis who had dyspnea and continuous cough For six months and who was finally recognized with continuous eosinophilic pneumonia is reported. Prolonged-time period corticosteroid remedy was needed As a Outcome of of recurrence of the continuous eosinophilic pneumonia all by way of tapering of the corticosteroid. As a steroid sparing stpricegy, mepolizumab was initiated, and the steroid was tapered progressively. When the dose of prednisolone was 2 mg/day, he developed polyartworkhralgia. Mepolizumab was modified to benralizumab confacetring The probability that artworkhralgia was a facet influence of mepolizumab; however, the artworkhralgia continued and he was finally recognized with rheumatoid artworkhritis. Methotrexate was initiated and his artworkhritis improved. Thereafter, benralizumab was discontinued after 5 injections, and he subsequently required neither systemic corticosteroids nor biologics.
Conclusion: The current case might advocate that suppression of IL-5 induces rheumatoid artworkhritis in sure affected particular persons; however, Furthermore It is potential that preliminary steroid remedy improved subclinical RA and made it stay unrecognized, and the parallel OCS tapering all by way of IL-5 remedy might have contrihowevered to unveil the underlying RA. Further research are required To decide ideas on the optimum use of anti-IL-5 remedy and To know the interplays between continuous eosinophilic pneumonia, anti-IL-5 remedy, tapering of corticosteroid and enchancment of rheumatoid artworkhritis.

Key phrases: bronchial asthma, continuous eosinophilic pneumonia, rheumatoid artworkhritis, mepolizumab, benralizumab

Introduction

Humanized monoclonal antibody to interleukin-5 (IL-5; mepolizumab) or the α-chain of the IL-5 receptor (benralizumab) is influenceive remedy for eosinophilic bronchial asthma, continuous eosinophilic pneumonia (CEP), and completely different eosinophilic illnesss.¹ However, enchancment of artworkhritis is A potential concern given thOn The Outcomeant suppression of allergic Th2 cytokines would shift the cytokine stability in the direction of Th1- and Th17-associated responses, Which might Finish in numerous inflammatory illnesss, collectively with rheumatoid artworkhritis (RA).² Right here, we describe the case of a affected person with CEP who was deal withed with long-time period oral glucocorticoid and developed RA all by way of anti-IL-5 remedy and tapering of the glucocorticoid. Initial corticosteroid remedy Could have suppressed RA symptom to make it stayed …….

Source: https://www.dovepress.com/development-of-rheumatoid-arthritis-during-anti-interleukin-5-therapy–peer-reviewed-fulltext-article-JAA