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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Anti-il-6 receptor tocilizumab in refractory graves’ orbitopathy: National multicenter observational study of 48 patients
Journal of Clinical Medicine, Volume 9, No. 9, Article 2816, Year 2020
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Description
Graves’ orbitopathy (GO) is the most common extrathyroidal manifestation of Graves’ disease (GD). Our aim was to assess the efficacy and safety of Tocilizumab (TCZ) in GO refractory to conventional therapy. This was an open-label multicenter study of glucocorticoid-resistant GO treated with TCZ. The main outcomes were the best-corrected visual acuity (BVCA), Clinical Activity Score (CAS) and intraocular pressure (IOP). These outcome variables were assessed at baseline, 1st, 3rd, 6th and 12th month after TCZ therapy onset. The severity of GO was assessed according to the European Group on Graves’ Orbitopathy (EUGOGO). We studied 48 (38 women and 10 men) patients (95 eyes); mean age ± standard deviation 51 ± 11.8 years. Before TCZ and besides oral glucocorticoids, they had received IV methylprednisolone (n = 43), or selenium (n = 11). GO disease was moderate (n =29) or severe (n = 19) and dysthyroid optic neuropathy (DON) (n = 7). TCZ was used in monotherapy (n = 45) or combined (n = 3) at a dose of 8 mg/kg IV every four weeks (n = 43) or 162 mg/s.c. every week (n = 5). TCZ yielded a significant improvement in all of the main outcomes at the 1st month that was maintained at one year. Comparing the baseline with data at 1 year all of the variables improved; BCVA (0.78 ± 0.25 vs. 0.9 ± 0.16; p = 0.0001), CAS (4.64 ± 1.5 vs. 1.05 ± 1.27; p = 0.0001) and intraocular pressure (IOP) (19.05 ± 4.1 vs. 16.73 ± 3.4 mmHg; p = 0.007). After a mean follow-up of 16.1 ± 2.1 months, low disease activity (CAS ≤ 3), was achieved in 88 eyes (92.6%) and TCZ was withdrawn in 29 cases due to low disease activity (n = 25) or inefficacy (n = 4). No serious adverse events were observed. In conclusion, TCZ is a useful and safe therapeutic option in refractory GO treatment. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Authors & Co-Authors
Sánchez-Bilbao, Lara
Spain, Santander
Universidad de Cantabria
Martínez-López, David
Spain, Santander
Universidad de Cantabria
Atienza-Mateo, Belén
Spain, Santander
Universidad de Cantabria
Maíz Alonso, Olga
Spain, Donostia-san Sebastian
Osakidetza, Donostia University Hospital
García-Aparicio, Ángel María
Spain, Toledo
Complejo Hospitalario de Toledo
Peiteado, Diana
Spain, Madrid
Hospital Universitario la Paz
Tomero, Eva Gloria
Spain, Madrid
Hospital Universitario de la Princesa
Aurrecoechea, Elena
Spain, Torrelavega
Hospital Sierrallana
Conesa, Arantxa
Spain, Valencia
Hospital Clinico Universitario de Valencia
Calvo-Río, Vanesa
Spain, Santander
Universidad de Cantabria
Demetrío-Pablo, Rosalía
Spain, Santander
Universidad de Cantabria
González-Mazón, Íñigo
Spain, Santander
Universidad de Cantabria
Herńandez, José L.
Spain, Santander
Universidad de Cantabria
Castañeda, Santos
Spain, Madrid
Hospital Universitario de la Princesa
Spain, Madrid
Universidad Autónoma de Madrid
González-Gay, Miguel Ángel
Spain, Santander
Universidad de Cantabria
Blanco-Alonso, Ricardo
Spain, Santander
Universidad de Cantabria
Statistics
Citations: 34
Authors: 16
Affiliations: 16
Identifiers
Doi:
10.3390/jcm9092816
ISSN:
20770383
Research Areas
Health System And Policy
Study Design
Cohort Study
Participants Gender
Male
Female