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[Persistent aphthous mouth ulcers associated with tocilizumab: two cases]
M Samimi1, F Lauferon, B Hüttenberger
1Université François-Rabelais, 10, boulevard Tonnellé, BP 3223, 37032 Tours cedex 1, France. samimi.mahtab@yahoo.fr
Annales De Dermatologie Et De Venereologie
|February 12, 2013
Summary
Tocilizumab (TCZ) can cause recurrent mouth ulcers, a rare side effect. Withdrawal of TCZ resolved ulcers, and reintroduction caused recurrence, confirming TCZ as the cause.
Area of Science:
- Immunology
- Rheumatology
- Pharmacology
Background:
- Tocilizumab (TCZ) is an interleukin-6 receptor inhibitor used for rheumatological conditions.
- Infections are the most common adverse events associated with TCZ.
- This study reports recurrent aphthous mouth ulcers as a novel side effect of TCZ.
Purpose of the Study:
- To describe the occurrence of recurrent aphthous mouth ulcers in patients treated with TCZ.
- To establish the causative role of TCZ in the development of these ulcers.
Main Methods:
- Case report of two patients treated with TCZ for rheumatological diseases.
- Observation of oral ulcer development after TCZ administration.
- Assessment of ulcer resolution after TCZ withdrawal and recurrence upon reintroduction.
Main Results:
- Both patients developed painful mouth ulcers weeks after TCZ treatment initiation.
- Oral ulcers resolved within 6-7 weeks of TCZ discontinuation.
- Reintroduction of TCZ led to rapid recurrence of oral ulcers in both patients.
Conclusions:
- Tocilizumab (TCZ) can induce recurrent aphthous mouth ulcers.
- Positive rechallenge confirmed the causal relationship between TCZ and oral ulcers.
- These mucosal side effects, though paradoxical, may involve inflammatory mechanisms and can potentially be managed with TCZ continuation and colchicine.
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