Use of the abatacept in a patient with psoriatic arthritis.
Psoriatic arthritis (PA) is an inflammatory seronegative arthritis of unknown origin. Classically, PA has five clinical forms, and asymmetric oligoarthritis is the most common type. We describe the case of a patient with PA refractory to disease-modifying drugs, who developed drug-induced hepatitis after chemoprophylaxis with isoniazid, administered prior to the treatment with an anti-TNFα agent. Due to the risk of activating latent tuberculosis with the administration of anti-TNFα and hepatotoxicity onset caused by the TB treatment and based on the fact that the treatment of PA is similar to the treatment of rheumatoid arthritis, a decision was made to use the empirical treatment with abatacept. Approximately twenty days after the second infusion of the drug, the patient showed clinical improvement, resolution of the arthritis, almost complete disappearance of the skin lesions and improvement of anemia and inflammatory tests.
Rheumatology Department, Hospital Geral de Fortaleza, Ceará, Brazil. carlosewerton123@gmail.com
Carlos Ewerton Maia
CE
Rodrigues
Francisco José Fernandes
FJ
Vieira
Maria Roseli Monteiro
MR
Callado
Kirla Wagner Poti
KW
Gomes
José Eyorand Castelo Branco
JE
de Andrade
Walber Pinto
WP
Vieira
D000069594:Abatacept; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D005260:Female; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use*; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D018796:Immunoconjugates; D014409:Tumor Necrosis Factor-alpha; D000069594:Abatacept