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A 75-year-old woman developed disseminated Nocardia nova infection while being treated with tocilizumab for giant cell arteritis. She had a history of giant cell arteritis and was also taking prednisolone and methotrexate. The infection was found in various parts of her body, including muscles, bones, tissue, lungs, and brain. The infection was considered to be a result of the tocilizumab treatment. She was treated with imipenem/cilastatin antibiotics. [Extracted from the article]

A study involving 108 patients with urothelial cancer found that seven patients developed various toxicities while being treated with pembrolizumab. The toxicities included arthritis, myositis, myocarditis, thyroiditis, fatigue, dermatitis, and giant cell arteritis. The patients discontinued pembrolizumab therapy after experiencing these adverse effects. The study did not provide information about the ages, sexes, or specific treatment details of the patients. [Extracted from the article]

A multicentre study involving 116 patients with giant cell arteritis (GCA) and unilateral permanent visual ischemia (PVI) found that some patients experienced adverse effects during treatment with methylprednisolone or prednisone. Two patients in the intravenous methylprednisolone (IV-MP) group developed palpitations and angina, which were attributed to the medication. In the direct prednisone group, one patient developed paroxysmal atrial fibrillation and another developed peritonitis, both considered to be side effects of prednisone. The study highlights potential toxicities associated with these medications in the treatment of GCA complicated by unilateral PVI. [Extracted from the article]

Two case studies were presented in which women developed giant cell arteritis while being treated with zoledronic acid for postmenopausal osteoporosis. In the first case, a 79-year-old woman experienced severe body aches, fever, hand pain, and stiffness after receiving the medication. She was diagnosed with rheumatoid arthritis flare and later with giant cell arteritis. Treatment with prednisone and tocilizumab resolved her symptoms. In the second case, a 69-year-old woman developed fever and joint pain after receiving zoledronic acid. She was diagnosed with inflammatory arthritis and giant cell arteritis based on clinical manifestations and imaging findings. Treatment with prednisone improved her condition. [Extracted from the article]

A 79-year-old man with giant cell arteritis (GCA) experienced a lack of efficacy with prednisolone treatment. While receiving prednisolone, he was diagnosed with pneumonia and developed abdominal pain after meals. Despite receiving fluid therapy, his condition worsened, and he developed hypotension and hyperlacticaemia. He underwent surgery, which revealed irreversible small bowel transmural ischaemia, leading to his death. It was concluded that the lack of efficacy of prednisolone contributed to the development of mesenteric arterial occlusion and mesenteric ischaemia related to GCA. [Extracted from the article]

A 79-year-old man with giant cell arteritis (GCA) experienced a lack of efficacy with prednisolone treatment. While receiving prednisolone, he was diagnosed with pneumonia and developed abdominal pain after meals. Despite receiving fluid therapy, his condition worsened, and he developed hypotension and hyperlacticaemia. He underwent surgery, which revealed irreversible small bowel transmural ischaemia, leading to his death. It was concluded that the lack of efficacy of prednisolone contributed to the development of mesenteric arterial occlusion and mesenteric ischaemia related to GCA. [Extracted from the article]

A retrospective case series of five patients with giant cell arteritis (GCA) found that two patients, a 73-year-old man and an 83-year-old woman, did not respond to treatment with methylprednisolone and tocilizumab. The man experienced rapid bilateral vision loss despite receiving both medications, while the woman had a reduction in visual acuity in her left eye. Both patients showed no improvement in their condition after five days of treatment. These findings suggest that methylprednisolone and tocilizumab may not be effective for GCA in some cases. [Extracted from the article]

A 76-year-old woman with a medical history of hypertension, Alzheimer's disease, and hypercholesterolemia experienced a lack of efficacy during treatment with methylprednisolone for giant cell arteritis. She presented with cognitive impairment and visual impairment, and further examination confirmed the diagnosis. Despite being initiated on methylprednisolone therapy, there was no improvement in her cognitive state and visual disturbance. [Extracted from the article]

A 75-year-old woman experienced a lack of efficacy while being treated with prednisolone and methylprednisolone for giant cell arteritis (GCA) and acute ischaemic optic neuropathy. She presented to the emergency department with acute chest pain and was diagnosed with GCA seven days prior. Despite being treated for acute coronary syndrome, her angiogram was normal. She later developed signs of an ischemic stroke and acute optic neuropathy. Further imaging revealed medullary infarction and mid-septal changes consistent with a recent infarct. She was subsequently started on tocilizumab for refractory GCA and secondary prevention medications. [Extracted from the article]

A 67-year-old woman with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) developed drug intolerance while being treated with tocilizumab, leflunomide, and sulfasalazine. She also experienced muscle weakness while taking prednisolone. Initially, she had a good response to high doses of prednisolone, but in 2020, she had a relapse and was unable to tolerate the other medications. She required high doses of prednisolone and methotrexate to manage her symptoms. The muscle weakness she experienced was likely due to the long-term use of prednisolone. After tapering her prednisolone dose, her symptoms improved, although she still had some pain. [Extracted from the article]

A 70-year-old woman developed diabetic ketoacidosis (DKA) while being treated with prednisone for suspected giant cell arteritis (GCA). She had symptoms of polyuria, polydipsia, and weakness for two weeks before presenting at the emergency room. She also experienced vision loss in her right eye. Laboratory tests confirmed DKA, which was likely caused by the high dose of prednisone. Further imaging revealed a pituitary cyst or adenoma. The woman's DKA was successfully treated, and she was recommended for outpatient endocrinology follow-up and elective surgery for her vision loss. [Extracted from the article]

A 65-year-old woman with a history of type 2 diabetes and dyslipidemia was treated with prednisolone for polymyalgia rheumatica. However, she exhibited a lack of efficacy, experiencing persistent symptoms such as anorexia and headache. Two weeks later, she presented with increased joint pain and pain in the temporomandibular joint, indicating that the prednisolone was not effective. Further diagnosis revealed that she had giant cell arteritis, and she was subsequently treated with methotrexate and unspecified steroids, which led to the resolution of her symptoms. [Extracted from the article]

A 72-year-old woman developed excited catatonia while being treated with prednisone for temporal arteritis. She exhibited bizarre behaviors such as frequent verbigeration, posturing, and stereotypies. After further assessment, she was diagnosed with excited catatonia due to prednisone. Treatment with lorazepam resolved her symptoms, and she was admitted to the internal medicine service. Her prednisone was switched to tocilizumab, and benzodiazepines were tapered without a recurrence of catatonia. [Extracted from the article]

A study described 12 patients, aged 72-89 years, who developed methotrexate toxicity resulting in mucositis and bone marrow suppression during treatment for various conditions such as rheumatoid arthritis, psoriatic arthritis, psoriasis, giant cell arteritis, and myositis. The patients also experienced drug interactions between methotrexate and other medications such as omeprazole, pantoprazole, torasemide, xipamide, or levetiracetam, which contributed to the toxicity. One patient accidentally overdosed on methotrexate. The patients were admitted to the hospital and received supportive therapy with folinic acid. While most patients recovered, one patient with septicaemia eventually died. [Extracted from the article]

An 80-year-old man developed nocardiosis while being treated with prednisone and tocilizumab for giant cell arteritis (GCA). He also experienced an allergic reaction while being treated with cotrimoxazole for the nocardiosis. The man initially presented with persistent headache and stiffness in the shoulder girdle muscles, leading to a diagnosis of GCA. After starting prednisone and tocilizumab therapy, he developed severe headache and retrosternal pain, leading to a suspected non-ST-elevation myocardial infarction (NSTEMI). However, further tests ruled out NSTEMI and revealed a mass in the lung, which was diagnosed as nocardiosis. The man was treated with cotrimoxazole, but had an allergic reaction and was switched to amoxicillin/clavulanic-acid. After two years of follow-up, the nocardiosis resolved and there was no recurrence of GCA symptoms. [Extracted from the article]

Post immunisation, 24 patients developed new onset rheumatic diseases, which included rheumatic polymyalgia (10 patients), microcrystalline wrist arthritis (1 patient), microcrystalline proximal interphalangeal hand arthritis (1 patient), adult onset Still disease (3 patients), cutaneous purpura (1 patient), ocular myositis (1 patient), undifferentiated seronegative polyarthritis (3 patients), undifferentiated seronegative monoarthritis (3 patients) and undifferentiated seronegative oligoarthritis (1 patient). Second line treatments included canakinumab (1 patient), joint corticosteroid injection (1 patient), methotrexate (1 patient), colchicine (1 patient), and belimumab and rituximab (1 patient). Following first or second line treatment, 25 patients showed complete response, et al. patients exhibited partial response, and the outcome for the remaining one patient was unknown. [Extracted from the article]

Thereafter, the patients developed vasculitis in the form of myositis and arteritis (1 patient); immune complex vasculitis (3 patients); giant cell arteritis (2 patients); left temporal artery vasculitis (1 patient); carotid artery arteritis (1 patient) following COVID-19 vaccination. The patients were treated with unspecified glucocorticoid (7 patients) along with cyclophosphamide (1 patient); NSAID (1 patient). [Extracted from the article]

However, he developed chronic transplant rejection despite immunosuppression therapy, indicating lack of efficacy to tacrolimus and prednisone. Owing to development of chronic transplant rejection and acute inflammatory optic neuropathy despite the immunosuppression therapy, lack of efficacy to tacrolimus and prednisone was concluded. Case 2: A 68-year-old man, who had undergone bilateral lung transplant for idiopathic pulmonary fibrosis, started receiving prophylactic immunosuppression therapy with tacrolimus, mycophenolate and oral prednisone 5mg. [Extracted from the article]

Patient 2: The patient, who had LV-GCA, started receiving SC methotrexate at the dose of 15mg weekly. Patient 1: The patient, who had LV-GCA, started receiving SC methotrexate at the dose of 20mg weekly. Patient 5: The patient, who had LV-GCA, started receiving leflunomide at the dosage of 10mg daily. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 76-year-old man developed radiculopathy during treatment with tocilizumab for giant cell arteritis [ I dosage and route not stated i ]. Following a reintroduction of high-dose steroid with cyclophosphamide, he remained well with no recurrence of chest pain 3 months after his presentation with aortic dissection. The CT angiogram confirmed stanford type B acute aortic dissection extending from the left subclavian artery to the external iliac vessels and presence of extracranial large-vessel vasculitis was confirmed on positron emission tomography CT scan. [Extracted from the article]

However, he had gastrointestinal intolerance and exacerbation of his cytopenia due to mycophenolate treatment. Therefore, the man started receiving off-label treatment with tofacitinib 5mg twice daily from June 2022 for VEXAS syndrome [ I duration of treatment to reactions onsets and outcomes not stated i ]. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 71-year-old man developed gastrointestinal intolerance and exacerbation of cytopenia during off-label treatment with mycophenolate for vacuoles, E1 enzyme, et al. linked, auto-inflammatory, somatic (VEXAS) syndrome [ I route and dosage not stated i ]. [Extracted from the article]