Tocilizumab for Rheumatoid Meningitis in Elderly Patients: A Report of Two Cases

Area of Science:

• Neurology
• Rheumatology
• Immunology

Background:

• Rheumatoid meningitis (RM) is a rare neurological complication of rheumatoid arthritis (RA).
• It can manifest as hypertrophic pachymeningitis and leptomeningitis.
• Elderly patients with RA face unique challenges in managing neurological complications.

Purpose of the Study:

• To evaluate the efficacy of tocilizumab in treating rheumatoid meningitis.
• To assess the safety and steroid-sparing potential of tocilizumab in elderly patients with RM.
• To report on clinical and radiological outcomes in patients treated with tocilizumab for RM.

Main Methods:

• Retrospective case review of two elderly patients with rheumatoid meningitis.
• Initial treatment with high-dose corticosteroids.
• Subsequent administration of tocilizumab for steroid-sparing effect.
• Assessment of clinical and radiological improvements.

Main Results:

• Both patients experienced significant clinical and radiological improvements after tocilizumab treatment.
• Tocilizumab facilitated successful tapering of corticosteroid therapy.
• No major adverse events were reported during tocilizumab treatment.

Conclusions:

• Tocilizumab is an effective treatment option for rheumatoid meningitis, particularly in elderly patients.
• Tocilizumab offers a valuable steroid-sparing strategy, mitigating risks associated with long-term corticosteroid use.
• Further research is warranted to confirm these findings in a larger cohort.