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.
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http://dx.doi.org/10.5606/tftrd.2023.11091 | DOI Listing |
Mult Scler Relat Disord
December 2024
Department of Otorhinolaryngology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Background: Dizziness and balance disturbances are common in patients with MS. Subjective visual vertical (SVV) is a test of vestibular perception that allows clinicians to evaluate the integration of multiple sensory inputs for spatial orientation in the CNS. We hypothesize that central vestibular impairment caused by active MS lesions may be reflected in the modified SVV testing.
View Article and Find Full Text PDFJ AAPOS
December 2024
Department of Ophthalmology, Brown University Warren Alpert Medical School and Rhode Island Hospital (RIH), Providence, Rhode Island; Pediatric Ophthalmology and Strabismus Associates, Providence, Rhode Island.
Endocrine
December 2024
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, Kartal, Istanbul, Turkey.
Objectives: The relationship between elevated ferritin levels and metabolic abnormalities in PCOS patients, and whether ferritin is a cause or a consequence, is still debated. This study aimed to evaluate the impacts of the fourth generation combined oral contraceptive containing ethinyl estradiol/drospirenone (EE 30 mcg/DRSP 3 mg), known for its favorable metabolic profile and lower side effect risk, on iron metabolism in PCOS patients, while also exploring the potential relationship between metabolic parameters and iron status.
Methods: The retrospective analysis was conducted on 81 women aged 18-45, diagnosed with PCOS according to the Rotterdam criteria and treated with EE/DRSP for six months.
Pharmacol Res
January 2025
UniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia 5000, Australia. Electronic address:
Gut microbial dysbiosis or altered gut microbial consortium, in schizophrenia suggests a pathogenic role through the gut-brain axis, influencing neuroinflammatory and neurotransmitter pathways critical to psychotic, affective, and cognitive symptoms. Paradoxically, conventional psychotropic interventions may exacerbate this dysbiosis, with antipsychotics, particularly olanzapine, demonstrating profound effects on microbial architecture through disruption of bacterial phyla ratios, diminished taxonomic diversity, and attenuated short-chain fatty acid synthesis. To address these challenges, novel therapeutic strategies targeting the gut microbiome, encompassing probiotic supplementation, prebiotic compounds, faecal microbiota transplantation, and rationalised co-pharmacotherapy, show promise in attenuating antipsychotic-induced metabolic disruptions while enhancing therapeutic efficacy.
View Article and Find Full Text PDFJ Med Ethics
December 2024
Weill Cornell Medical College, New York, New York, USA.
There is increasing evidence for the use of open-label placebo (OLP) as an effective and safe treatment for a range of chronic conditions. OLP is generally conceived as an ethical alternative to classic placebo treatment because patients know that they are taking a placebo and are hence not deceived. However, despite its potential benefits and lack of side effects, the paradoxical nature of OLP may make it difficult to propose as a treatment option in clinical practice.
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