Effects of iguratimod in the treatment of palindromic rheumatism: Case report.

Objective: Palindromic rheumatism (PR) is characterized by interstitial inflammation, redness, and pain in joints and periarticular tissues. However, the pathogenesis and treatment of PR remain unknown. Herein, we report on the first use of iguratimod (IGU) - a novel small-molecule compound with anti-inflammatory effects - in the treatment of refractory PR.

Case: A male patient aged 70 years was diagnosed with PR based on medical history, clinical manifestations, and ultrasound findings. The patient was treated with IGU (25 mg PO q.d.). The disease activity was measured by the frequency of PR flares and clinical symptoms. The patient's laboratory tests were monitored for safety reasons.

Results: The use of IGU significantly improved pain symptoms and reduced flare frequency. After 28 days of treatment, abnormal levels of glutamic-pyruvic transaminase were observed. One month after discontinuation of IGU, flares occurred in the patient's second toe of both feet.

Conclusion: IGU provides a new treatment option for patients with refractory PR who cannot use hydroxychloroquine. The effective treatment with IGU suggests the potential pathogenesis of PR and provides a basis for physicians to choose a new drug for PR treatment.