June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Long-term treatment with Tocilizumab for non-infectious uveitis
Author Affiliations & Notes
  • Marina Mesquida
    Ophthalmology, Hospital Clinic de Barcelona, Barcelona, Spain
  • Blanca Molins
    Ophthalmology, Hospital Clinic de Barcelona, Barcelona, Spain
  • Victor Llorens
    Ophthalmology, Hospital Clinic de Barcelona, Barcelona, Spain
  • Anna Sala-Puigdollers
    Ophthalmology, Hospital Clinic de Barcelona, Barcelona, Spain
  • Jessica Matas
    Ophthalmology, Hospital Clinic de Barcelona, Barcelona, Spain
  • Javier Zarranz-Ventura
    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; Blanca Molins, None; Victor Llorens, None; Anna Sala-Puigdollers, None; Jessica Matas, None; Javier Zarranz-Ventura, None; Maite Sainz De La Maza, None; Alfredo Adan Civera, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 3112. doi:
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      Marina Mesquida, Blanca Molins, Victor Llorens, Anna Sala-Puigdollers, Jessica Matas, Javier Zarranz-Ventura, Maite Sainz De La Maza, Alfredo Adan Civera, ; Long-term treatment with Tocilizumab for non-infectious uveitis. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3112.

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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-6 receptor antagonist tocilizumab (TCZ) for refractory uveitis and its related macular edema (ME).

 
Methods
 

Data were obtained by standardized chart review. Main outcome measures: central foveal thickness (CFT) measured by optical coherence tomography, anterior chamber cell grade, vitreous haze, and best-corrected visual acuity (logarithm of the minimum angle of resolution [log-MAR]) were recorded during TCZ therapy at months 1, 3, 6, 12, 18, and 24.

 
Results
 

Seventeen eyes from 12 patients (10 females) were included. Mean age was 38.6 years. Mean duration of ME was 12.3 years. Mean follow-up with TCZ therapy was 21.8 months (range, 6-24). Before TCZ, all patients failed conventional immunosuppressive therapy and one or more biologic agents. Uveitis diagnoses were: juvenile idiopathic arthritis-associated-uveitis (n=5), birdshot chorioretinopathy (n=3), idiopathic panuveitis (n=2), sympathetic ophthalmia (n=1), and ankylosing spondylitis (n=1). Mean CFT (95% confidence interval) was 530 ± 194 μm in baseline, 370 ± 95 μm at month 1 (p= 0.004), 303 ±78 μm at month 3 (p=0.0009), 275 ± 72 μm at month 6 (p= 0.000025), 288 ± 107 at month 12 (p=0.002), and 297 ± 99 at month 24 (p=0.015) of follow-up. TCZ’s major efficacy on CFT can be observed at months 6 to 9 (nadir), reaching a plateau from month 12 of follow-up onwards.<br /> Mean log-MAR best-corrected visual acuity improved from 0.72 ± 0.65 in baseline to 0.54 ± 0.62 at month 6 (p = 0.0019), 0.54 ± 0.65 at month 12 (p = 0.007), and 0.6 ± 0.76 at month 24 (p = 0.02). TCZ therapy was withdrawn in 2 patients due to sustained remission at month 12. In both patients, ME relapsed 3 months after TCZ withdrawal. Reinitiation of TCZ therapy led to good uveitis control and ME resolution. With regards to safety, one patient developed mild neutropenia and another patient showed increased liver enzymes, none of which required TCZ withdrawal.

 
Conclusions
 

TCZ may be safe and effective for uveitis and its associated ME in otherwise refractory cases.  

 

 
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