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Anti-interleukin-6 receptor tocilizumab for severe juvenile idiopathic arthritis-associated uveitis refractory to anti-tumor necrosis factor therapy: a multicenter study of twenty-five patients

Abstract: Objective: To assess the efficacy of tocilizumab (TCZ) for the treatment of juvenile idiopathic arthritis (JIA)-associated uveitis. Methods: We conducted a multicenter study of patients with JIA-associated uveitis that was refractory to conventional immunosuppressive drugs and anti-tumor necrosis factor (anti-TNF) agents. Results: We assessed 25 patients (21 female; 47 affected eyes) with a mean?±?SD age of 18.5?±?8.3 years. Uveitis was bilateral in 22 patients. Cystoid macular edema was present in 9 patients. Ocular sequelae found at initiation of TCZ included cataracts (n?=?13), glaucoma (n?=?7), synechiae (n?=?10), band keratopathy (n?=?12), maculopathy (n?=?9), and amblyopia (n?=?5). Before TCZ, patients had received corticosteroids, conventional immunosuppressive drugs, and biologic agents (median 2 [range 1-5]), including adalimumab (n?=?24), etanercept (n?=?8), infliximab (n?=?7), abatacept (n?=?6), rituximab (n?=?2), anakinra (n?=?1), and golimumab (n?=?1). Patients received 8 mg/kg TCZ intravenously every 4 weeks in most cases. TCZ yielded rapid and maintained improvement in all ocular parameters. After 6 months of therapy, 79.2% of patients showed improvement in anterior chamber cell numbers, and 88.2% showed improvement after 1 year. Central macular thickness measured by optical coherence tomography in patients with cystoid macular edema decreased from a mean?±?SD of 401.7?±?86.8 ?m to 259.1?±?39.5 ?m after 6 months of TCZ (P?=?0.012). The best-corrected visual acuity increased from 0.56?±?0.35 to 0.64?±?0.32 (P?

 Fuente: Arthritis and Rheumatology, 2017, 69(3), 668-675

 Publisher: John Wiley and Sons Ltd

 Year of publication: 2017

 No. of pages: 8

 Publication type: Article

 DOI: 10.1002/art.39940

 ISSN: 2326-5205,2326-5191

Authorship

CALVO RÍO, VANESA

SANTOS GÓMEZ, MONTSERRAT

PALMOU FONTANA, NATALIA

JAVIER LORICERA GARCIA

ROSALIA DEMETRIO PABLO