Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.16/2598 |
Resumo: | Fasciitis with eosinophilia (FE) is a rare connective tissue disease. Due to its rarity, large-scale studies are lacking, which makes its treatment challenging. Systemic corticosteroids (SCSs) are the cornerstone of treatment; however, additional immunosuppressive drugs (ISDs) are frequently necessary (usually methotrexate). We report 2 patients, for whom an SCS and methotrexate were not a viable long-term option. In the first case, we were unable to taper the SCS dose without symptom relapse, the patient showed only a partial response to methotrexate and presented side effects. The second case never fully responded to the SCS and methotrexate and demonstrated serious SCS adverse effects. Both patients were started on tocilizumab with extremely favourable results, making this drug a potential therapeutic weapon for these patients. Learning points: The treatment of FE is challenging and mainly based on retrospective reviews, open-label trials and case reports, all of which included a small number of patients.Currently, systemic corticosteroids are the mainstay of treatment; however, other ISDs are frequently necessary.Cases showing a favourable clinical response to tocilizumab have recently been described in patients with corticosteroid-refractory disease, suggesting that this drug may potentially become a therapeutic weapon for these patients. |
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Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case ReportsEosinophilic fasciitisShulman’s diseasetocilizumabFasciitis with eosinophilia (FE) is a rare connective tissue disease. Due to its rarity, large-scale studies are lacking, which makes its treatment challenging. Systemic corticosteroids (SCSs) are the cornerstone of treatment; however, additional immunosuppressive drugs (ISDs) are frequently necessary (usually methotrexate). We report 2 patients, for whom an SCS and methotrexate were not a viable long-term option. In the first case, we were unable to taper the SCS dose without symptom relapse, the patient showed only a partial response to methotrexate and presented side effects. The second case never fully responded to the SCS and methotrexate and demonstrated serious SCS adverse effects. Both patients were started on tocilizumab with extremely favourable results, making this drug a potential therapeutic weapon for these patients. Learning points: The treatment of FE is challenging and mainly based on retrospective reviews, open-label trials and case reports, all of which included a small number of patients.Currently, systemic corticosteroids are the mainstay of treatment; however, other ISDs are frequently necessary.Cases showing a favourable clinical response to tocilizumab have recently been described in patients with corticosteroid-refractory disease, suggesting that this drug may potentially become a therapeutic weapon for these patients.SMC MediaRepositório Científico do Centro Hospitalar Universitário de Santo AntónioPinheiro, Maria GuiomarCosta, Ana RitaCampar, AnaMendonça, Teresa2021-11-22T15:09:50Z2020-03-022020-03-02T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.16/2598engPinheiro G, Costa AR, Campar A, Mendonça T. Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports. Eur J Case Rep Intern Med. 2020;7(4):001485. doi:10.12890/2020_0014852284-259410.12890/2020_001485info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-10-20T11:01:13Zoai:repositorio.chporto.pt:10400.16/2598Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:38:47.776097Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports |
title |
Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports |
spellingShingle |
Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports Pinheiro, Maria Guiomar Eosinophilic fasciitis Shulman’s disease tocilizumab |
title_short |
Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports |
title_full |
Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports |
title_fullStr |
Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports |
title_full_unstemmed |
Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports |
title_sort |
Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports |
author |
Pinheiro, Maria Guiomar |
author_facet |
Pinheiro, Maria Guiomar Costa, Ana Rita Campar, Ana Mendonça, Teresa |
author_role |
author |
author2 |
Costa, Ana Rita Campar, Ana Mendonça, Teresa |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
Repositório Científico do Centro Hospitalar Universitário de Santo António |
dc.contributor.author.fl_str_mv |
Pinheiro, Maria Guiomar Costa, Ana Rita Campar, Ana Mendonça, Teresa |
dc.subject.por.fl_str_mv |
Eosinophilic fasciitis Shulman’s disease tocilizumab |
topic |
Eosinophilic fasciitis Shulman’s disease tocilizumab |
description |
Fasciitis with eosinophilia (FE) is a rare connective tissue disease. Due to its rarity, large-scale studies are lacking, which makes its treatment challenging. Systemic corticosteroids (SCSs) are the cornerstone of treatment; however, additional immunosuppressive drugs (ISDs) are frequently necessary (usually methotrexate). We report 2 patients, for whom an SCS and methotrexate were not a viable long-term option. In the first case, we were unable to taper the SCS dose without symptom relapse, the patient showed only a partial response to methotrexate and presented side effects. The second case never fully responded to the SCS and methotrexate and demonstrated serious SCS adverse effects. Both patients were started on tocilizumab with extremely favourable results, making this drug a potential therapeutic weapon for these patients. Learning points: The treatment of FE is challenging and mainly based on retrospective reviews, open-label trials and case reports, all of which included a small number of patients.Currently, systemic corticosteroids are the mainstay of treatment; however, other ISDs are frequently necessary.Cases showing a favourable clinical response to tocilizumab have recently been described in patients with corticosteroid-refractory disease, suggesting that this drug may potentially become a therapeutic weapon for these patients. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-03-02 2020-03-02T00:00:00Z 2021-11-22T15:09:50Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.16/2598 |
url |
http://hdl.handle.net/10400.16/2598 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Pinheiro G, Costa AR, Campar A, Mendonça T. Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports. Eur J Case Rep Intern Med. 2020;7(4):001485. doi:10.12890/2020_001485 2284-2594 10.12890/2020_001485 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
SMC Media |
publisher.none.fl_str_mv |
SMC Media |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799133648438427648 |