Efficacy and Safety of Tocilizumab in the Management of Non-Infectious Uveitis Failed with Conventional Immunomodulatory and Anti-TNFα Therapies

Ocul Immunol Inflamm. 2024 Aug;32(6):891-897. doi: 10.1080/09273948.2022.2126374. Epub 2022 Dec 21.

Abstract

Purpose: To determine the outcomes of intravenous (IV) tocilizumab (TCZ) in patients with non-infectious uveitis who failed with conventional immunomodulatory and anti-TNFα therapies.

Methods: Records of seven patients with non-infectious uveitis treated with monthly IV TCZ (4-10 mg/kg) or biweekly IV TCZ (8 mg/kg) were reviewed. Outcome measures were changes in visual acuity, anterior chamber cell and flare grade, vitreous haze, central subfield thickness (CST), and fluorescein angiography (FA) score.

Results: Ten eyes of seven patients received TCZ therapy. Median age of patients was 14 (range, 7-24) years. Median duration of TCZ therapy was 15 (range, 5-32) months. Mean CST reduced from 373 ± 101.0 μm to 298.2 ± 40.3 μm. Mean FA score reduced from 12.5 ± 4.3 to 3.6 ± 2.6. One patient developed elevated liver transaminases.

Conclusion: IV TCZ is a potentially effective and safe therapeutic option for the management of refractory non-infectious uveitis.

Keywords: Central subfield thickness; fluorescein angiography score; non-infectious uveitis; retinal vasculitis; tocilizumab.

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Child
  • Female
  • Fluorescein Angiography*
  • Humans
  • Male
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha* / antagonists & inhibitors
  • Uveitis* / diagnosis
  • Uveitis* / drug therapy
  • Visual Acuity* / physiology
  • Young Adult

Substances

  • tocilizumab
  • Antibodies, Monoclonal, Humanized
  • Tumor Necrosis Factor-alpha