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Scandinavian Journal of Rheumatology Volume 53, 2024 - Issue 2
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Letters

When treatment takes a turn: tocilizumab-induced bowel perforation in a patient with COVID-19-afflicted rheumatoid arthritis

W-H Yoo1 Department of Internal Medicine, Division of Rheumatology, Jeonbuk National University Medical School, Jeonju, South Korea;2 Research Institute of Clinical Medicine of Jeonbuk National University – Biomedical Research Institute, Jeonbuk National University, Jeonju, South KoreaORCID Iconhttps://orcid.org/0000-0002-8430-7629View further author information
ORCID Icon,
GW Ha2 Research Institute of Clinical Medicine of Jeonbuk National University – Biomedical Research Institute, Jeonbuk National University, Jeonju, South Korea;3 Department of Surgery, Jeonbuk National University Medical School, Jeonju, South KoreaORCID Iconhttps://orcid.org/0000-0001-9401-1760View further author information
ORCID Icon,
KM Kim2 Research Institute of Clinical Medicine of Jeonbuk National University – Biomedical Research Institute, Jeonbuk National University, Jeonju, South Korea;4 Department of Pathology, Jeonbuk National University Medical School, Jeonju, South KoreaORCID Iconhttps://orcid.org/0000-0001-7074-7183View further author information
ORCID Icon &
Y Choi1 Department of Internal Medicine, Division of Rheumatology, Jeonbuk National University Medical School, Jeonju, South Korea;2 Research Institute of Clinical Medicine of Jeonbuk National University – Biomedical Research Institute, Jeonbuk National University, Jeonju, South KoreaCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-7922-0705View further author information
ORCID Icon
Pages 155-157 | Received 16 Oct 2023, Accepted 11 Dec 2023, Published online: 10 Jan 2024

References

  • Smolen JS, Landewé RBM, Bergstra SA, Kerschbaumer A, Sepriano A, Aletaha D, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis 2023;82:3–18.
  • Mikuls TR, Johnson SR, Fraenkel L, Arasaratnam RJ, Baden LR, Bermas BL, et al. American College of Rheumatology guidance for the management of rheumatic disease in adult patients during the COVID-19 pandemic: version 3. Arthritis Rheumatol 2021;73:e1–12.
  • World Health Organization. WHO coronavirus (COVID-19) dashboard. [cited 2023 Sep 26]. Available from: https://covid19.who.int/.
  • Alzahrani OR, Alanazi AD, Hawsawi YM, Alatwi HE, Alharbi AA. Gastrointestinal manifestations of COVID-19: an updated systematic review. Trop Biomed 2022;39:428–33.
  • Al Argan RJ, Alqatari SG, Al Said AH, Alsulaiman RM, Noor A, Al Sheekh LA, et al. Gastrointestinal perforation secondary to COVID-19: case reports and literature review. Medicine (Baltimore) 2021;100:e25771.
  • Strangfeld A, Richter A, Siegmund B, Herzer P, Rockwitz K, Demary W, et al. Risk for lower intestinal perforations in patients with rheumatoid arthritis treated with tocilizumab in comparison to treatment with other biologic or conventional synthetic DMARDs. Ann Rheum Dis 2017;76:504–10.
  • Monemi S, Berber E, Sarsour K, Wang J, Lampl K, Bharucha K, et al. Incidence of gastrointestinal perforations in patients with rheumatoid arthritis treated with tocilizumab from clinical trial, postmarketing, and real-world data sources. Rheumatol Ther 2016;3:337–52.
  • Rempenault C, Lukas C, Combe B, Herrero A, Pane I, Schaeverbeke T, et al. Risk of diverticulitis and gastrointestinal perforation in rheumatoid arthritis treated with tocilizumab compared to rituximab or Abatacept. Rheumatology (Oxford) 2022;61:953–62.
  • Saad E, Awadelkarim A, Agab M, Babkir A. Tocilizumab-associated small bowel perforation in a young patient with rheumatoid arthritis: a lesson to remember during COVID-19 pandemic. J Med Cases 2022;13:135–9.

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