April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Long-term effects of tocilizumab therapy for uveitic macular edema
Author Affiliations & Notes
  • Marina Mesquida
    Ophthalmology, Hospital Clinic de Barcelona, Barcelona, Spain
  • Victor Llorens
    Ophthalmology, Hospital Clinic de Barcelona, Barcelona, Spain
  • Blanca Molins
    Ophthalmology, Hospital Clinic de Barcelona, Barcelona, Spain
  • Maite Sainz de la Maza
    Ophthalmology, Hospital Clinic de Barcelona, Barcelona, Spain
  • Alfredo Adan Civera
    Ophthalmology, Hospital Clinic de Barcelona, Barcelona, Spain
  • Footnotes
    Commercial Relationships Marina Mesquida, None; Victor Llorens, None; Blanca Molins, None; Maite Sainz de la Maza, None; Alfredo Adan Civera, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 107. doi:
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    • Get Citation

      Marina Mesquida, Victor Llorens, Blanca Molins, Maite Sainz de la Maza, Alfredo Adan Civera; Long-term effects of tocilizumab therapy for uveitic macular edema. Invest. Ophthalmol. Vis. Sci. 2014;55(13):107.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To report the long-term efficacy and safety of the IL-6R antagonist tocilizumab (TCZ) for uveitic macular edema (UME) refractory to immunomodulatory therapy.

 
Methods
 

Five refractory patients with UME who received TCZ infusions between January 2012 and October 2013 were identified by retrospective chart review. All patients received 8 mg/kg TCZ at 4-weeks intervals. Main outcome measures: Central foveal thickness (CFT) measured by optical coherence tomography, degree of anterior and posterior chamber inflammation (Standardization of Uveitis Nomenclature Working Group criteria), and visual acuity (logarithm of the minimum angle of resolution [log-MAR]) were recorded during TCZ therapy at months 1, 3, 6, and 12.

 
Results
 

Eight eyes from 5 patients (all females) were included. Mean age was 51.4 years. Mean follow-up was 15 months (range, 12-18). Before TCZ, all patients failed conventional IS therapy and had received at least 1 another biologic agent. Uveitis diagnoses were: Birdshot chorioretinopathy (n=3), juvenile idiopathic arthritis-associated-uveitis (n=1), and idiopathic panuveitis (n=1). Mean baseline CFT (95% confidence interval) was 602 ± 236 μm in baseline, 386 ± 113 μm at month 1 (p= 0.006), 323 ± 103 μm at month 3 (p= 0.026), 294.5 ± 94.5 μm at month 6 (p= 0.014), and 266 ± 74.4 at month 12 of follow-up (p=0.006). Median log-MAR best-corrected visual acuity (BCVA) improved from 0.66 ± 0.57 in baseline to 0.47 ± 0.62 at month 12 (p = 0.018). TCZ therapy was withdrawn in 2 patients due to sustained remission at 12 months. In one patient UME relapsed and TCZ had to be restarted, while the other patient remained UME-free until last follow-up. TCZ was generally well tolerated and no serious adverse events were reported.

 
Conclusions
 

These data suggest that TCZ is effective for treating UME in otherwise refractory cases.

     
Keywords: 745 uvea • 746 uveitis-clinical/animal model • 557 inflammation  
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