Tocilizumab in the treatment of refractory uveitis associated with juvenile idiopathic arthritis

Abstract

Purpose : To analyze the efficacy of the anti-IL-6R antibody tocilizumab (TCZ) for the treatment of severe and refractory chronic uveitis associated with juvenile idiopathic arthritis (JIA).

Methods : This retrospective analysis was performed by members of the multinational interdisciplinary working group for uveitis in childhood (MIWGUC). JIA patients receiving TCZ treatment due to active and refractory uveitis were included in this analysis. JIA and related uveitis data (disease onset, activity, structural complications, topical and systemic anti-inflammatory treatment, eye surgery) at TCZ start (baseline), and at 3, 6, 9, and 12 months after TCZ start were evaluated.

Results : A total of 17 patients (14 female) with active uveitis (n=17) were included (mean age 15.3 ± 6.9 years, mean follow-up time 8.4 months). In all patients, uveitis had been refractory to previous topical and systemic corticosteroids, methotrexate and other synthetic disease modifying drugs, and at least one TNF-alpha inhibitor. Uveitis inactivity was achieved in 10 patients after a mean of 5.7 months of TCZ treatment (in 3 of them recurrence later on), and remained active in another 7 patients. Macular edema was present in 5 patients at baseline, and improved in all of them under TCZ treatment. Arthritis was active in 10 patients at initial visit, and in 5 patients at final visit.

Conclusions : TCZ may be a therapeutic option for selected patients with severe JIA associated uveitis that has been refractory to methotrexate and TNF inhibitors.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.