Table 1.
Patients‘ characteristics and treatment information.
| Patient A | Patient B | ||
|---|---|---|---|
| Age at time of diagnosis (y) | 28 | 30 | |
| Origin | Caucasian / Europe | Caucasian/Europe | |
| Medical history | Hypothyroidism | No other diseases or comorbidities | |
| Family history | Inconspicuous | Inconspicuous | |
| Previous pregnancies | None | One pregnancy with an uncomplicated course and a healthy child | |
| Smoking status | Former smoker | Non-smoker | |
| Body weight; Body mass index (BMI) |
69 kg ; 26 kg/m² | 55 kg; 20.7 kg/m² | |
| Clinical manifestations | |||
| Vestibulo-auditory manifestations | bilateral hearing impairment, unilateral hearing loss (right ear), bilateral tinnitus, vertigo |
bilateral hearing impairment, unilateral hearing loss (left ear), bilateral tinnitus, vertigo | |
| Eye manifestations | Bilateral interstitial keratitis Bilateral conjunctivitis |
Bilateral conjunctivitis | |
| General symptoms | fever, weight loss, arthralgia | subfebrile temperature, fatigue, myalgia | |
| Other physical examination including neurological status | unremarkable | unremarkable | |
| C-reactive protein serum concentration as biomarker for disease activity | |||
| CRP before CZP | 28.3 mg/L | 6 mg/L | |
| CRP within the first 3 months of CZP | Normalization to values <5 mg/L | Normalization to values <5 mg/L | |
| CRP during follow-up under CZP | At normal dose <5 mg/L, After dose reduction <10 mg/L, After treatment cessation >10 mg/L |
Continuously <5 mg/L | |
| Treatment before start of CZP | |||
| Topical treatment | 5% Dexpanthenol eye and nose ointment (Bepanthen®), Eye drops with hyaluronic acid for dry eyes during episodes of keratitis |
Intratympanic steroid injection, 5% Dexpanthenol eye and nose ointment (Bepanthen®), Eye drops with hyaluronic acid for dry eyes during episodes of conjunctivitis |
|
| Prednisolone treatment | |||
| intravenous bolus | PRED 3× 250 mg | PRED 3× 250 mg | |
| initial oral dose | PRED 60 mg/day | PRED 15 mg/day | |
| long term dose | PRED ≥ 10 mg/day | 0 | |
| treatment duration | 32 months | 11 months | |
| Synthetic DMARDs | AZA 100 mg/day MTX 20 mg/week |
AZA 100 mg/day | |
| Biological DMARDs | ADA 40 mg EOW | ADA 40 mg EOW | |
ADA, adalimumab; AZA, azathioprine; BMI, body mass index; CRP, c-reactive protein; CZP, certolizumab pegol; DMARDs, disease modifying antirheumatic drugs; EOW, every other week; IGRA, interferon-gamma release assay; MTX, methotrexate; PRED, prednisone; y, years.