Turkish Journal of Physical Medicine and Rehabilitation 2024 , Vol 70 , Num 1

Is there a paradoxical side effect? Is it a case of inefficiency? Peripheral ulcerative keratitis in a patient with rheumatoid arthritis in remission treated with tocilizumab

Yasemin Tombak 1 ,Methiye Kubra Sezer 1 ,Ajda Bal 1 ,Emel Eksioglu 1 ,Deniz Dulgeroglu 1
1 Department of Physical Therapy and Rehabilitation, University of Health Sciences, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye DOI : 10.5606/tftrd.2023.11091 Tocilizumab is a monoclonal antibody to interleukin-6 that has recently been used in rheumatoid arthritis (RA) treatment. Treatment with tocilizumab may be associated with paradoxical manifestations that are poorly understood. Patients that developed peripheral ulcerative keratitis while on tocilizumab treatment were studied in a case series. It was discovered that this could be a paradoxical side effect or ineffectiveness. Herein, we present a patient with seropositive RA who was followed for 22 years, using tocilizumab for seven years, and who developed peripheral ulcerative keratitis while in remission. Consequently, even in remission, extra-articular involvement can occur in RA patients, and medication-related paradoxical side effects can arise. Keywords : Peripheral ulcerative keratitis, rheumatoid arthritis, tocilizumab