Successful Treatment of a Patient with Rheumatoid Arthritis and IgA-Kappa Multiple Myeloma with Tocilizumab

Matsuyama, Yasushi; Nagashima, Takao; Honne, Kyoko; Kamata, Yasuyuki; Iwamoto, Masahiro; Okazaki, Hitoaki; Sato, Kazuya; Ozawa, Keiya; Minota, Seiji

doi:10.2169/internalmedicine.50.4636

Cited by 22 publications

(13 citation statements)

References 11 publications

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“…Für Patienten mit RA kann man sich vor allem auf die Arbeit von van Vollenhoven et al berufen, die sogenannte "ungünstige Ereignisse von Interesse" unter Rituximab-Therapie über einen Nachbeobachtungszeitraum von 9,5 Jahren im gesamten Studienprogramm von Rituximab auswertet [ 38 ] . [ 41 ] . Nach Umstellen der Biologikatherapie auf Tocilizumab kam es zunächst zu einem steilen Anstieg von IgA, im Verlauf stabilisierte sich dieser Wert aber und blieb den gesamten Beobachtungszeitraum von 13 Monaten auf ungefähr der gleichen Höhe.…”

Section: Rituximabunclassified

Immunsuppressive Therapie bei Tumoranamnese

Schmalzing

Tony

2014

Akt Rheumatol

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▼As far as the question is concerned whether immunosuppressive therapy is feasible and safe in a patient with a history of malignoma, only fairly insuffi cient data is available. Nevertheless, the Société Francaise de Rhumatologie, the Canadian Rheumatology Association, and the American College of Rheumatology have tried to make recommendations for this delicate topic. Direct evidence mainly originates from data of 3 national registries which suggest that treatment with traditional disease-modifying anti-rheumatic drugs (DMARDs) and biologics seems safe for carefully selected patients. Furthermore, conclusions can be drawn from the experience with immunosuppressive medication in the transplant setting. With the exception of cyclophosphamide in a high cumulative dosage, for which an increased risk of malignoma is evident, all traditional DMARDs, all immunosuppressants and all biologics available probably do not lead to an increased risk of de novo malignancy in spite of sometimes confl icting data. The current data for each drug of interest is presented. Finally, an algorithm for treating patients with a history of malignoma with immunosuppressive drugs is suggested.Heruntergeladen von: Rutgers University. Urheberrechtlich geschützt.

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Section: Rituximabunclassified

Immunsuppressive Therapie bei Tumoranamnese

Schmalzing

Tony

2014

Akt Rheumatol

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“…Matsuyama et al . reported a patient with rheumatoid arthritis (RA) and smoldering MM, in whom TCZ improved RA symptoms and also stabilized the serum levels of monoclonal IgA .…”

Section: Moabs Targeting Components Of Bone Marrow Milieumentioning

confidence: 99%

“…Tocilizumab treatment is generally well tolerated and safe. It is now evaluated in open‐label phase I (USA) and II (France) trials to assess its safety and efficacy as monotherapy in MM patients who are not candidates for, or who have relapsed after SCT .…”

Section: Moabs Targeting Components Of Bone Marrow Milieumentioning

confidence: 99%

Monoclonal antibodies: potential new therapeutic treatment against multiple myeloma

Allegra

Penna

Alonci

et al. 2013

European J of Haematology

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Despite recent treatments, such as bortezomib, thalidomide, and lenalidomide, therapy of multiple myeloma (MM) is limited, and MM remains an incurable disease associated with high mortality. The outcome of patients treated with cytotoxic therapy has not been satisfactory. Therefore, new therapies are needed for relapsed MM. A new anticancer strategy is the use of monoclonal antibodies (MoAbs) that represent the best available combination of tumor cytotoxicity, environmental signal privation, and immune system redirection. Clinical results in patients with relapsed/refractory MM suggest that MoAbs are likely to operate synergistically with traditional therapies (dexamethasone), immune modulators (thalidomide, lenalidomide), and other novel therapies (bortezomib); in addition, MoAbs have shown the ability to overcome resistance to these therapies. It remains to be defined how MoAb therapy can most fruitfully be incorporated into the current therapeutic paradigms that have achieved significant survival earnings in patients with MM. This will require careful consideration of the optimal sequence of treatments and their clinical position as either short-term induction therapy, frontline therapy in patients ineligible for ASCT, or long-term maintenance treatment.

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“…Another interesting possibility is to combine bortezomib with other drugs now being used for treating myelomas. These include the immunomodulatory drugs thalidomide and lenalidomide, drugs blocking the interactions that maintain plasma cells in their survival niches in the bone marrow (natalizumab 65 against VLA‐4, tocilizumab 66 or siltuximab 67 against IL6, and plerixafor 68 against CXCR4), or drugs reactive with plasma cells directly (elotuzumab 69 against CS1, daratumumab 70 against CD38, or nBT062 71 against CD138).…”

Section: Proteasome Inhibitors For Myasthenia Gravis Patients?mentioning

confidence: 99%

Targeting plasma cells with proteasome inhibitors: possible roles in treating myasthenia gravis?

Gomez

Willcox

Molenaar

et al. 2012

Annals of the New York Academy of Sciences

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Myasthenia gravis (MG) is treated primarily with broad-spectrum immuno-suppressants such as prednisone or azathioprine, which normally require several months to reduce autoantibody titers significantly. This delay may be caused by the resistance of the main antibody-producing cells, the plasma cells, to these drugs. In particular, long-lived plasma cells are resistant to immunosuppressive treatments and can produce (auto-) antibodies for months. Bortezomib is a proteasome inhibitor approved for treating patients with multiple myeloma, a plasma cell malignancy. Recent preclinical studies in cell cultures and animal models, and clinical studies in organ-transplant recipients, have demonstrated that bortezomib can kill non-neoplastic plasma cells within hours. This suggests that proteasome inhibitors could also be used for rapidly reducing autoantibody production in autoimmune diseases. We have begun to assess their potential in MG.

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Successful Treatment of a Patient with Rheumatoid Arthritis and IgA-Kappa Multiple Myeloma with Tocilizumab

Cited by 22 publications

References 11 publications

Immunsuppressive Therapie bei Tumoranamnese

Immunsuppressive Therapie bei Tumoranamnese

Monoclonal antibodies: potential new therapeutic treatment against multiple myeloma

Targeting plasma cells with proteasome inhibitors: possible roles in treating myasthenia gravis?

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