Session Type: ACR Concurrent Abstract Session
Session Time: 4:30PM-6:00PM
To assess the efficacy of Tocilizumab (TCZ) in refractory uveitis associated to juvenile idiopathic arthritis (JiA).
Multicenter study of uveitis related to JiA and refractory to at least a) one standard synthetic immunosuppressive drug and, b) one anti-TNFα drug.
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).
Tocilizumab seems to be effective and relatively safe in refractory uveitis related to JiA.
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 January 25, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/tocilizumab-in-refractory-uveitis-associated-to-juvenile-idiopathic-arthritis-multicenter-study-of-13-cases/