M. Papo, P. Bielefeld, H. Vallet, P. Seve, B. Wechsler, P. Cacoub, P. Le Hoang, T. Papo, B. Bodaghi, D. Saadoun
Service de Médecine Interne, Hôpital Pitié-Salpêtrière 47-83 boulevard de l'Hôpital 75013 Paris, France. firstname.lastname@example.org
2014 Vol.32, N°4 ,Suppl.84 - PI 0075, PF 0079
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To report the safety and efficacy of tocilizumab in patients with severe and refractory non-infectious uveitis.
Eight consecutive unselected patients with severe and refractory non-infectious uveitis [Birdshot chorioretinopathy (n=1), Behçet`s disease (n=1) and idiopathic bilateral panuveitis (n=6)] treated with tocilizumab (8mg/kg every 4 weeks intravenously) were included. The primary outcome was the response to treatment, defined by decrease of inflammatory ocular signs.
Four (50%) patients were of female gender and the median (IQR) age was 41 (31-47) years. The median number of previous immunosupressants was of 5.5 (4–6.7). Seven patients had been previously treated with anti-TNF-α [infliximab (n=5) and adalimumab (n=2)]. The immunosupressive drugs used in association with tocilizumab were azathioprine (n=2), mycophenolate mofetil (n=2) and methotrexate (n=2). After a median follow-up of 8 months (6–25), 6/8 (75%) improved under tocilizumab and 2 (25%) were non-responders. The visual acuity improved in five patients. The median dose of prednisolone decreased from 16mg/day (10.6–20.5) to 10 mg/day (10–13.7), at baseline and at the end of follow-up, respectively. Tolerance of tocilizumab was satisfactory and side effects included bronchitis (n=1) and grade 1 leukopenia (n=1) and thrombocytopenia (n=1).
Tocilizumab seems to be a safe and promising therapy in severe and refractory non-infectious uveitis.
PMID: 25268663 [PubMed]
Received: 06/01/2014 - Accepted : 15/05/2014 - In Press: 30/09/2014 - Published: 30/09/2014