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Abstract
Systemic sclerosis (SSc) presents stiffness of extremities due to sclerosis of the tissue especially at fingers, hands, and forearms. Here we report the case of a patient with diffuse cutaneous SSc who was administered anti-interleukin-6 receptor antibody tocilizumab (TCZ). Skin condition of SSc is evaluated by pinching the skin according to the Rodnan skin score, but sometimes tissue atrophy results in overestimation of the condition. To understand how the extremities softened after initiation of TCZ, we observed mobility of extremities. Range of motion (ROM) of joints was measured every four months after initiation of TCZ. The patient presented not only reduction of Rodnan score but also amelioration of mobility of extremities. The Rodnan skin score reduced from 35 to 7 within sixteen months, and ROM of most joints except ankle was expanded.
Acknowledgments
Our heartfelt appreciation goes to Dr. Kuwahara, Dr. Watanabe, and Dr. Kawai, whose outstanding medical work was of inestimable value for our study. We are indebted to Dr. Iwatani, Dr. Sakata, Dr. Okano, and Dr. Takahashi, whose extensive knowledge in nephrology, cardiology, and gastroenterology made an enormous contribution to our work. This work was supported by the Program for Promotion of Fundamental Studies in Health Sciences of the National Institute of Biomedical Innovation, Japan.
Conflict of interest
T. Kishimoto holds a patent for TCZ, and receives royalties for ACTEMRA®. A. Ogata received a consulting fee from Chugai Pharmaceutical Co. Ltd. for providing medical advice. Other authors have no conflict of interest to declare.