Ozoralizumab-Induced Multifocal Demyelinating Neuropathy in a Patient With Rheumatoid Arthritis

Tumor 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.