Table 1.
Previous reports of successful treatment of rheumatoid arthritis-associated amyloidosis with biologic agents.
| Author, year [Ref.] | Study design | Gender and age | Amyloidosis related symptoms | Involved organ | Disease duration | Used biologic agents or targeted synthetic DMARDs | Doses, routes of drug administration | Prior therapy | Outcome |
| Sawamura et al. 2020 sh[42] | Case report | F/72 | Diarrhea | Large intestine | 50 yr | ABA | 750 mg, IV, monthly | Anti-TNF agents, TCZ | Improved |
| Kovács et al. 2020 [31] | Case report | F/52 | Microscopic hematuria | kidney | 30 yr | TCZ | IV, monthly | Gold salt, MTX, LEF, ETA | Improved |
| Fukuda et al. 2021 [32] | Case reports (n = 2) | F/59M/71 | Deteriorating renal function | Kidney and duodenum | TCZ | 8mg/kg, monthly | Patient 1; Gold salt, BCA, ETAPatient 2; BCA, ETA, ABA | Improved | |
| Nakamura et al. 2019 [4] | Retrospective study (n = 15) | Upper gastrointestinal | ETA, TCZ, ABA | - | - | TCZ: Worse5: Expired | |||
| Shimagami et al. 2019 [20] | Case report | F/77 | Massive ascites | Rectum | 40 yr | TCZ | 320 mg IV twice and then 162 mg SQ | SZP | Improved |
| Kilic et al. 2018 [45] | Retrospective study (n = 4) | F = 4, mean age 55.5 | Kidney | 18.8 years | Rituximab (n = 4) | Two endogenous IV infusions of Ig per treatment cycle separated by a two-week interval | MTX, SSZ, HCQ, LEF, CS, ETA, ADM | 3: Switch to TCZ1: Improved | |
| Galmiche et al. 2018 [23] | Case report | F/78 | Diarrhea and leg edema | Duodenum | 0 | TCZ | 8mg/kg, monthly | MTX | Improved |
| Watanabe et al. 2018 [46] | Case report | F/76 | Pitting edema | kidney | 16 yr | Tofacitinib | Anti-TNF agents, TCZ, ABA | Improved | |
| Yamagata et al. 2017 [24] | Case report | F/67 | Diarrhea and pedal edema | Colon and kidney | TCZ | 8mg/kg, monthly | SZP | Improved | |
| Pamuk et al. 2016 [48] | Retrospective study (n = 30) | M = 11/F = 19, Mean age 51.7 | Proteinuria (29), ESRD (1) | Kidney | 14.2 yr | Anti-TNF agents (n = 23), RTM (n = 10), ABA (n = 5), TCZ (n = 4), ANA (n = 1) | - | MTX, SZP, LEF | 12: Improved |
| Courties et al. 2015 [29] | Retrospective study (n = 8) | M = 2/F = 6Mean age 69.9 | Renal failure | Kidney, liver, duodenum | 17.1 yr | TCZ | 8mg/kg, IV, every 4 wk | MTX, HCQ, SSZ, ETA, ADA, ABA | 6: Improved |
| Lane et al. 2015 [30] | Case series (n = 7) | M = 3/F = 4 | Renal impairment | Kidney | TCZ | 8mg/kg, IV, every 4 wk | MTX, SSZ, ETA, RTX, LFM | 1: complete response6: partial response | |
| Yamada et al. 2014 [25] | Case report | F/71 | Nephrotic syndrome | Kidney | 15 yr | TCZ | 8mg/kg, IV, every 4 wk | BCA | Improved |
| Matsui et al. 2014 [26] | Case report | F/60s | Heart failure and renal dysfunction | Kidney, stomach | 10 yr | TCZ | 8mg/kg, IV, every 4 wk | MTX, BCA | Improved |
| Miyagawa et al. 2014 [28] | Case series (n = 5) | All female, Mean age 59.2 | Renal involvement | Kidney, GI | 20.2 yr | TCZ | 8mg/kg, IV, every 4 wk | MTX, AZ, BCA, ETA | Improved |
| Nakamura et al. 2014 [41] | Case series (n = 2) | F/70, F/65 | Refractory diarrhea, weight loss, proteinuria | KidneyGI | ABA | 500 mg IV monthly | MTX, ETA, TCZ | Improved | |
| Vinicki et al. 2013 [19] | Case report | F/48 | Hematuria | Kidney | 10 yr | TCZ | 8mg/kg, IV, every 4 wk | MTX, SZP | Improved |
| Burkart et al. 2013 [44] | Case report | F/61 | N.A. | N.A | 34 yr | RTX | ADA | Improved | |
| Fikri-Benbrahim et al. 2013 [40] | Two case reports | F/57F/78 | ProteinuriaDilated cardiomyopathy and CKD | Kidney | 8 yr | ADA | MTX | 1: Improved1: expired | |
| Hakala M et al. 2013[27] | Case series (RA = 3) | M/53M/60F/64 | proteinuria | Kidney | TCZ | 8mg/kg, monthly | DMARDs, ETA, ADA | 2: Improved1: Maintained | |
| Nakamura et al. 2012 [39] | Retrospective study (n = 24) | M = 4/F = 20 | Proteinuria, thyroid dysfunction, weight loss, repeated constipation and diarrhea | Kidney, GI | 16.2 yr | ETA | MTX (62.5%) | ETN: Improved in survival and mean GFR | |
| Kuroda et al. 2012 [47] | Retrospective study (n = 53) | M = 7, F = 46, Mean age 63.2 | Kidney involvement | Kidney | 16.8 yr | ETA, IFX, TCZ | 7: expired9: HD | ||
| Hattori et al. 2012 [33] | Case report | F/58 | Cardiac and kidney involvement | Cardiac involvement | 10 yr | TCZ | 8mg/kg, IV, every 4 wk | Gold, BCA, ETA | Improved |
| Narvaez J et al. 2011[43] | Case series (RA = 4) | All F, 46 - 75 | Kidney, gastrointestinaltract, cardiac | 14 – 40 yr | RTX | 1g IV, 2 wk interval | MTX, IFX, ETA, ADM, AZ | 3: Improved1: Maintained | |
| Lee et al. 2011 [37] | Case report | F/62 | Diarrhea and abdominal pain | GI involvement | Long-standing | IFX | 5mg/kg at weeks 0, 2, and 6 | MTX, LEF | Improved |
| Inoue et al. 2010 [18] | Case report | F/64 | Persistent vomiting and diarrhea | GI involvement | 7 yr | TCZ | 8mg/kg, IV, every 4 wk | SSZ, BCM, MTX | Improved |
| Kuroda et al. 2009 [38] | Prospective study (n = 14) | M = 2, F = 12, Mean age 57.6 | N.A. | stomach | 15 yr | ETA (n = 10), IFX (n = 4) | ETA 25 mg SQ twice a wk, IFX 3 mg/kg at weeks 0, 2, and 6, and then every 8 wk. | Improved | |
| Sato H et al. 2009 [17] | Case report | F/53 | Diarrhea, Hypovolemic shock | GI involvement | 10 yr | TCZ | 8mg/kg, IV, every 4 wk | MTX, SZP | Improved |
| Nishida S et al. 2009 [22] | Case report | F/50 | Diarrhea, weight loss | GI involvement | 12 yr | TCZ | 8mg/kg, IV, every 4 wk | DMARD, ETA, IFX | Improved |
| Kuroda et al 2008 [36] | Case report | F/55 | Nephrotic syndrome | Kidney | 27 yr | IFX | MTX | Improved | |
| Ravindran et al. 2004 [34] | Case report | F/74 | Proteinuria | Kidney | 27 yr | ETA | 25 mg twice weekly SC | HCQ, gold, MTX | Regression of AA amyloid, no change in Felty's SD |
| Smith et al. 2004 [35] | Case report | F/56 | Proteinuria | Kidney | 17 yr | ETA | 25 mg twice weekly SC | HCQ, D-penicillamine, AZP, MTX | Improved |