Efficacy of tacrolimus in infliximab-refractory progressive rheumatoid arthritis

• Published in: Rheumatology international Vol. 29; no. 4; pp. 459 - 461
• Main Authors: Yokota, Kazuhiro, Akiyama, Yuji, Asanuma, Yu, Miyoshi, Fumihiko, Sato, Kojiro, Mimura, Toshihide
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.02.2009; Springer Nature B.V
• Subjects: Antibodies, Monoclonal - therapeutic use; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - therapy; Case Report; Disease Progression; Drug Resistance; Humans; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Infliximab; Male; Medicine; Medicine & Public Health; Middle Aged; Retreatment; Rheumatoid arthritis; Rheumatology; Tacrolimus - administration & dosage; Tacrolimus - adverse effects; Tacrolimus - therapeutic use; Treatment Outcome; FK506; Infliximab; Tacrolimus; Rheumatoid arthritis
• ISSN: 0172-8172; 1437-160X
• DOI: 10.1007/s00296-008-0694-5

We report a Japanese male patient with intractable rheumatoid arthritis (RA), in whom tacrolimus was effective ultimately. Five years before the admission he was diagnosed as RA, which was resistant to various disease-modifying anti-rheumatic drugs (DMARDs). Two years before, administration of infliximab was initiated although the medicine failed to control RA. In spite of the multiple joint replacement, the RA disease activity worsened. Tacrolimus (1.5 mg/day) was administered. Twenty-four weeks of tacrolimus treatment reduced the disease activity score for 28 joints-erythrocyte sedimentation rate from 7.44 to 3.65. Herein, we present a patient with RA, who was successfully treated by tacrolimus, and in whom infliximab was not effective. Tacrolimus may be one of the drugs for RA patients refractory to the conventional treatments including methotrexate or tumor necrosis factor inhibitors.