Anti-TNF treatment in ankylosing spondylitis patients with chronic kidney disease: Is it effective and safe?

Coşkun, Belkıs Nihan; Yağız, Burcu; Corabay, Seniha; Pehlıvan, Yavuz; Dalkılıç, Ediz

doi:10.5152/eurjrheum.2022.21099

Cited by 1 publication

(1 citation statement)

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“…Considering the patient’s liver damage and the risk of infections, we preferred monotherapy, which, for TCZ, is proven as effective as a combination therapy. In addition, there are currently no official recommendations regarding the use of TNFi in patients with ESRD, although limited publications suggest its safe and efficient use [ 28 , 29 ]. One of the possible treatment options could be abatacept, a fusion protein that acts as a T-cell co-stimulation inhibitor, but since it is not registered in our country, its use was not thoroughly considered.…”

Section: Discussionmentioning

confidence: 99%

Safe and Efficient Use of Tocilizumab in Rheumatoid Arthritis Patient on Maintenance Hemodialysis: A Case Report

Kilić,

Ikić,

Mayer

et al. 2023

Medicina

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Background: Rheumatoid arthritis (RA) is a chronic systemic autoimmune and inflammatory disease. Conventional synthetic and biologic disease-modifying antirheumatic drugs (DMARDs), Janus kinase inhibitors, and rituximab are used to treat the disease. There are no recommendations or guidelines for the treatment of patients with both inflammatory arthritis and end-stage renal disease (ESRD), despite the safety and efficacy of the mentioned drugs. The anti-interleukin-6 receptor antibody tocilizumab (TCZ) has not been used as a long-term therapy for hemodialysis (HD) patients with RA, except in a few case reports. Case Description: We present the case of a 41-year-old patient with RA and ESRD on maintenance HD due to type 1 diabetes-related complications. Due to high RA disease activity, the patient was not a suitable candidate for a kidney transplant. Because TCZ is used to treat both RA and kidney transplant rejection, therapy with a full dose of TCZ was administered. The patient has achieved sustained clinical remission (for the past four years) with no adverse events reported. Conclusions: Herein, we present the safe and effective use of TCZ in an RA patient on HD who is also a candidate for kidney transplant. Consequently, TCZ could be the treatment of choice for RA patients with ESRD who have not achieved disease control (low activity or remission) with conventional synthetic DMARDs. Clinical studies are required to evaluate the efficacy and safety of biologic DMARDs and Janus kinase inhibitors in patients with both inflammatory arthritis and ESRD.

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Section: Discussionmentioning

confidence: 99%