ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 3178

Tocilizumab in Refractory Uveitis Associated to Juvenile Idiopathic Arthritis. Multicenter Study of 13 Cases

Montserrat Santos-Gómez1, Vanesa Calvo-Río1, Ricardo Blanco1, Inmaculada Calvo2, Marina Mesquida3, Alfredo Adan3, M. Victoria Hernández4, Olga Maiz Alonso5, Antonio Atanes-Sandoval6, Beatriz Bravo7, Consuelo Modesto8, Gisela Diaz Soriano9, Javier Loricera1, Leyre Riancho-Zarrabeitia1, Natalia Palmou1 and Miguel Angel Gonzalez-Gay1, 1Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Santander, Spain, 2Rheumatology, Hospital La Fe, Valencia, Spain, 3Ophthalmology, Hospital Clinic, Barcelona, Spain, 4Arthritis Unit, Rheumatology, Hospital Clinic, Barcelona, Spain, 5Rheumatology, Donostia University Hospital, Donostia, Spain, 6Rheumatology, Complejo Hospitalario Universitario de La Coruña, La Coruña, Spain, 7Rheumatology, Hospital Universitario HUVN, Granada, Spain, 8Rheumatology, Hospital HSLL, Palma de Mallorca, Spain, 9Rheumatology, Hospital Regional Universitario de Málaga, Málaga, Spain

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: ,

Session Information

Date: Tuesday, November 10, 2015

Title: Pediatric Rheumatology - Clinical and Therapeutic Aspects IV: Imaging and Novel Clinical Interventions

Session Type: ACR Concurrent Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose:  

To assess the efficacy of Tocilizumab (TCZ) in refractory uveitis associated to juvenile idiopathic arthritis (JiA).

Methods:

Multicenter study of uveitis related to JiA and refractory to at least a) one standard synthetic immunosuppressive drug and, b) one anti-TNFα drug.

Results:

We studied 13 patients/24 eyes (11 women/2 men) with a mean age of 20.38±9 years (range 8-38). The most frequent ocular pattern was anterior uveitis (n=11), bilateral (n=11), and chronic (n=13).

Besides corticosteroids and before TCZ onset, they had received methotrexate (n=11), cyclosporine A (n=5), mycophenolate (n=1) and leflunomide (n=1). The first biological treatment was: adalimumab (ADA) (n=6) (40 mg/sc/2 weeks), infliximab (IFX) (n=3) (5 mg/kg/i.v./every 6-8 weeks) and etanercept (ETN) (n=4). Before TCZ onset they were switched to other biologic drug (n=11) (most of them due to inefficacy), a third (n=5), fourth (n=3) and a fifth biologic therapy (n=1). TCZ was used at a conventional dose (8 mg/kg/4 weeks) in most cases and combined in all cases (MTX=7, LFN=4, CsA=1, MMF=1). Improvement from baseline to 1 year was observed in: a) Visual acuity: from 0.46±0.35 to 0.52±0.37 (p=0.007); b) Anterior chamber cells from a median [IQR] of 1 [0.5-2] to 0 [0-0] (p=0.001), c) vitritis from 0 [0-1] to 0 [0-0] (p=0.06) and d) Macular thickness from a mean of 277±127 to 234±32 microns (p=0.04). After a mean follow-up of 15.2±8.3 months, ocular remission was achieved in 9 of 13 patients and adverse events were severe thrombocytopenia (n=1), pneumonia (n=1), viral conjunctivitis and bullous impetigo (n=1).

Conclusion:

Tocilizumab seems to be effective and relatively safe in refractory uveitis related to JiA.

Disclosure: M. Santos-Gómez, None; V. Calvo-Río, None; R. Blanco, None; I. Calvo, None; M. Mesquida, None; A. Adan, None; M. V. Hernández, None; O. Maiz Alonso, None; A. Atanes-Sandoval, None; B. Bravo, None; C. Modesto, None; G. Diaz Soriano, None; J. Loricera, None; L. Riancho-Zarrabeitia, None; N. Palmou, None; M. A. Gonzalez-Gay, None.

To cite this abstract in AMA style:

Santos-Gómez M, Calvo-Río V, Blanco R, Calvo I, Mesquida M, Adan A, Hernández MV, Maiz Alonso O, Atanes-Sandoval A, Bravo B, Modesto C, Diaz Soriano G, Loricera J, Riancho-Zarrabeitia L, Palmou N, Gonzalez-Gay MA. Tocilizumab in Refractory Uveitis Associated to Juvenile Idiopathic Arthritis. Multicenter Study of 13 Cases [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/tocilizumab-in-refractory-uveitis-associated-to-juvenile-idiopathic-arthritis-multicenter-study-of-13-cases/. Accessed .

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