[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-459110-105":59,"doc-detail-459110-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","ozoralizumab-induced-multifocal-demyelinating-neuropathy-in-a-patient-with-rheumatoid-arthritis","Ozoralizumab-Induced Multifocal Demyelinating Neuropathy in a Patient With Rheumatoid Arthritis","","Tumor necrosis factor-α inhibitors can induce demyelinating polyneuropathy, yet ozoralizumab has not previously been reported. A 57-year-old man with rheumatoid arthritis developed left-hand paresthesia, bilateral wrist drop, and reduced grip strength after starting ozoralizumab. Nerve conduction studies showed bilateral radial nerve conduction blocks consistent with demyelination. Symptoms persisted after stopping ozoralizumab and resolved after two intravenous immunoglobulin courses, with complete clinical and electrophysiological recovery, suggesting a triggering role.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/ozoralizumab-induced-multifocal-demyelinating-neuropathy-in-a-patient-with-rheumatoid-arthritis/459110/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/ozoralizumab-induced-multifocal-demyelinating-neuropathy-in-a-patient-with-rheumatoid-arthritis/459110.png","ImageObject",300,407,{"name":92,"@type":93},"acoobca","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-09","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What symptoms did the patient develop after starting ozoralizumab?","Question",{"text":113,"@type":114},"He developed paresthesia in the left hand, bilateral wrist drop, and reduced grip strength.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What did nerve conduction studies show?",{"text":118,"@type":114},"They showed bilateral radial nerve conduction blocks consistent with demyelination, while sensory nerves were normal.",{"name":120,"@type":111,"acceptedAnswer":121},"How were the symptoms treated and what was the outcome?",{"text":122,"@type":114},"After discontinuing ozoralizumab, two courses of intravenous immunoglobulin were given; symptoms resolved with complete clinical and electrophysiological recovery.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},459110,1790891297,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},3985747870733,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Review began 10/22/2025  \nReview ended 12/04/2025  \nPublished 12/09/2025  \n© Copyright 2025  \nIkegawa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98835  \nOpen Access Case Report  \nOzoralizumab-Induced Multifocal Demyelinating Neuropathy in a Patient With Rheumatoid Arthritis  \nYuya Ikegawa 1 , Yuichi Hamada 1, Naoki Hayakawa 1, Kazuto Nishinaka 1  \n1. Neurology, Sumitomo Hospital, Osaka, JPN  \nCorresponding author: Yuichi Hamada, [me19066@s.okayama-u.ac.jp](me19066@s.okayama-u.ac.jp)  \nAbstract  \nTumor necrosis factor-α (TNF-α) inhibitors can induce demyelinating polyneuropathy, but this has not been reported with ozoralizumab. We report a case of a 57-year-old male with rheumatoid arthritis who developed paresthesia in the left hand, bilateral wrist drop, and reduced grip strength after starting ozoralizumab. Nerve conduction studies showed bilateral radial nerve conduction blocks consistent with demyelination. Symptoms persisted after discontinuation of ozoralizumab but resolved after two courses of intravenous immunoglobulin therapy, with complete clinical and electrophysiological recovery. This case suggests that ozoralizumab may trigger multifocal demyelinating neuropathy.  \nCategories: Neurology, Rheumatology  \nKeywords: demyelinating diseases, ozoralizumab, peripheral nervous system diseases, rheumatoid arthritis, tumor necrosis factor inhibitors  \nIntroduction  \nTumor necrosis factor-α (TNF-α) inhibitors have greatly enhanced the management of inflammatory diseases such as rheumatoid arthritis (RA) and inflammatory bowel disease [1] . However, they have also been associated with demyelinating disorders affecting the central nervous system (CNS) or peripheral nervous system (PNS), including multiple sclerosis, optic neuritis, Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy [2-4].  \nOzoralizumab, a new TNF-α inhibitor, was approved for treating RA in Japan in 2022, but no PNS demyelinating disease associated with its use has been reported. This report presents the initial instance of multifocal demyelinating neuropathy possibly triggered by ozoralizumab in a patient with RA.  \nCase Presentation  \nA 57-year-old Japanese man presented with a 2-month history of left-hand paresthesia, bilateral wrist drop, and reduced grip strength. He had a 9-year history of RA, which remained in remission following treatment with methotrexate, tacrolimus, and tocilizumab. Ozoralizumab was initiated 7 months before presentation for a relapse of joint symptoms. Neurological symptoms appeared 5 months later, persisting for 2 months despite discontinuation of ozoralizumab.  \nNeurological examination showed bilateral weakness in muscles innervated by the median and radial nerves. Grip strength measured 9/7 kg (right/left) . Muscle strength was graded 5/5 bilaterally in the deltoid, biceps brachii, and triceps brachii; 4+/5 on the right and 2+/5 on the left in the wrist flexor (WF) ; 2/5 on the right and 5/5 on the left in the wrist extensor (WE) ; 4/5 on the right and 2/5 on the left in the abductor pollicis brevis (APB) ; 1/5 bilaterally in the extensor digitorum (ED) ; 5/5 bilaterally in the first dorsal interosseous and abductor digiti minimi ; 4-/5 on the right and 2+/5 on the left in the flexor digitorum profundus (FDP) of the first finger; 5/5 bilaterally in the FDP of the fourth finger; and 4/5 on the right and 2/5 on the left in the flexor pollicis longus (FPL) using the Medical Research Council (MRC) scales. No lower extremity weakness was present. Paresthesia affected the first to fourth fingers of the left hand. Cranial nerve function and gait were normal.  \nBlood tests indicated elevated levels of RA-related antibodies, including rheumatoid fa","cbCaisYe6MnJAo4m","https://ap.wps.com/l/cbCaisYe6MnJAo4m","pdf",388913,"English","# Abstract\n# Introduction\n# Case Presentation\n## Clinical presentation\n## Laboratory and cerebrospinal fluid findings\n## Nerve conduction study results","[{\"question\":\"What symptoms did the patient develop after starting ozoralizumab?\",\"answer\":\"He developed paresthesia in the left hand, bilateral wrist drop, and reduced grip strength.\"},{\"question\":\"What did nerve conduction studies show?\",\"answer\":\"They showed bilateral radial nerve conduction blocks consistent with demyelination, while sensory nerves were normal.\"},{\"question\":\"How were the symptoms treated and what was the outcome?\",\"answer\":\"After discontinuing ozoralizumab, two courses of intravenous immunoglobulin were given; symptoms resolved with complete clinical and electrophysiological recovery.\"}]","Ozoralizumab-Induced Multifocal Demyelinating Neuropathy in a Patient With Rheumatoid Arthritis | PDF",1790755220,15]