Tocilizumab
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Various toxicities: case report In a study of 9 patients, a 59-year-old woman was described, who developed bacterial infections, herpes zoster and osteomyelitis complicating one scleroderma digital ulcer during off-label treatment with tocilizumab for refractory scleroderma-associated interstitial lung disease (SSc-ILD). The woman, who had progressive SSc-ILD, received offlabel therapy with tocilizumab [dosage and route not stated] for atleast 6 months. Her ILD was found to be fibrosant nonspecific interstitial pneumonia. She had also received various immunosuppressants. Subsequently, during treatment with tocilizumab, she developed repeat infections including herpes zoster, bacterial infections and an osteomyelitis. Her osteomyelitis also complicated one scleroderma digital ulcer (worsening of scleroderma) and required hospitalisation [durations of treatment to reactions onsets and outcomes not stated]. The woman’s tocilizumab therapy was discontinued and was awaiting for lung transplantation. Author comment: "Based on this preliminary evidence, we have evaluated tocilizumab (off-label use) as a rescue therapy in nine selected patients". "The frequency of adverse events was low, occurring in only one patient (11%) who developed repeat infections including an osteomyelitis complicating a digital ulcer requiring hospitalisation." Narvaez J, et al. Effectiveness and safety of tocilizumab for the treatment of refractory systemic sclerosis associated interstitial lung disease: a case series. Annals of the Rheumatic Diseases 78: 214449, No. 11, Nov 2019. Available from: 803436211 URL: http://doi.org/10.1136/annrheumdis-2018-214449 - Spain
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Editorial comment: Details of this case report have previously been published [see Reactions 1743 p201; 803377964].
0114-9954/19/1781-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved
Reactions 30 Nov 2019 No. 1781
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