2017 Volume 29 Issue 3 Pages 190-196
We experienced the case of a 26-year old female patient with rheumatoid arthritis (RA) who was treated with subcutaneous (SC) tocilizumab (TCZ). We discontinued bucillamine and started iguratimod (IGU) to reduce her dose of prednisolone (PSL). However, her pain worsened and the dose of PSL was increased from 1.5 mg/day to 3 mg/day at 8 weeks after the introduction of IGU. Since she was 171 cm tall and weighed 65 kg, we switched from SC TCZ to intravenous (IV) TCZ. Her disease activity ―as measured by the clinical disease activity index and the level of matrix metalloproteinase-3― was ameliorated and we were able to reduce the dose of PSL to 2 mg/day. Introduction of IGU and switching to IV TCZ might be useful when the response to SC TCZ is insufficient in a patient who is relatively large in size.
