Tocilizumab Efficacy in a Patient with Positive Anti-CCP Chronic Lyme Arthritis.

Julianna Hirsch, Itzhak Rosner, Doron Rimar, Lisa Kaly, Michael Rozenbaum, Nina Boulman, Gleb Slobodin
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Abstract

Context: Lyme arthritis, a manifestation of tick-borne Lyme disease, can prove to be refractory to classic treatment.

Case report: We present a case of a 48-year-old male, diagnosed with chronic Lyme arthritis, refractory to recurrent and prolonged courses of doxycycline, ceftriaxone, as well as hydroxychloroquine and methotrexate. The patient responded partially to tumor necrosis factor (TNF)-alpha blockade by etanercept and, finally, entered long-term remission after his treatment was switched to tocilizumab.

Conclusion: Off label treatment by biologic disease modifying antirheumatic drugs can be considered in selected patients with severe antibiotic-resistant Lyme arthritis.C.

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托西珠单抗对一名抗CCP阳性慢性莱姆关节炎患者的疗效。
背景:莱姆关节炎是蜱媒莱姆病的一种表现形式,可能对传统治疗方法产生耐药性:我们报告了一例 48 岁男性患者的病例,他被诊断为慢性莱姆关节炎,对多西环素、头孢曲松、羟氯喹和甲氨蝶呤等药物的反复和长期治疗无效。患者对依那西普(etanercept)的肿瘤坏死因子(TNF)-α阻断治疗产生了部分反应,最后在改用西利珠单抗治疗后获得了长期缓解:结论:对于经过选择的严重抗生素耐药莱姆关节炎患者,可以考虑使用生物疾病修饰抗风湿药进行标签外治疗。
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