Table 1.

Patient characteristics, previous treatments, and RCI response

Case	Age (years)	Gender	Previous treatment failures	RCI response
1	88	F	Golimumab and etanercept due to lack of efficacy, infliximab due to infusion reaction, adalimumab due to injection site reaction, and cannot take methotrexate (renal insufficiency)	• Patient noted both skin and joint improvements on RCI • Patient responded better to a thrice a week dosing regimen, which offered fewer days between doses • After approximately 1.5 years on RCI, the patient noted a gradual decrease in her ability to carry out activities of daily life; however, this could be a result of natural aging • Patient tolerated RCI well
2	46	M	Adalimumab and certolizumab due to lack of efficacy	• Patient experienced remarkable improvements in skin and joint disease while on RCI  • Able to throw football with son for first time in 2 years  • Over time, effect of RCI did not seem to be as marked • RCI was discontinued due to worsening preexisting hypertension and weight gain
3	51	F	Certolizumab and adalimumab, due to lack of efficacy and infliximab due to infusion reactions	• Patient’s skin improved and joint disease essentially resolved with RCI • RCI was discontinued due to elevated blood pressure and weight gain
4	55	F	Etanercept, golimumab, infliximab, and adalimumab and stopped taking methotrexate (believed it was responsible for low hemoglobin levels)	• Patient had remarkable improvements in joint pain and stiffness • RCI was discontinued due to unrelated illness • Patient tolerated RCI well
5	58	M	Adalimumab and certolizumab due to lack of efficacy	• Patient noted marked joint improvements on RCI • Skin disease also improved but did not clear • RCI was used to transition therapy to apremilast • Patient tolerated RCI well
6	66	F	Methotrexate, adalimumab, and ustekinumab due to lack of efficacy	• Patient’s skin and joint disease greatly improved on RCI  • Patient had great amount of energy and was able to do yardwork • RCI was discontinued due to worsening hyperglycemia
7	37	M	Adalimumab due to lack of efficacy	• Patient experienced marked initial improvements in joint and skin disease on RCI • After 3 months of RCI, patient noted continued improvements in joint pain; however, his skin disease worsened • RCI was discontinued due to lack of skin improvement • Patient tolerated RCI well
8	69	F	Adalimumab, methotrexate, and certolizumab monotherapy due to lack of efficacy	• Patient experienced improvements in both skin and joint disease on RCI • RCI was used to successfully bridge ongoing therapy with certolizumab • Patient tolerated RCI well
9	48	F	Adalimumab and certolizumab due to lack of efficacy	• Patient had initial skin and joint improvements on RCI • After a 12-week course of RCI, the patient reported temporary joint improvements and did not have significant skin disease improvements  • RCI was discontinued • Patient tolerated RCI well

Abbreviations: F, female; M, male; RCI, repository corticotropin injection.