Tocilizumab as an alternative for corticosteroid-refractory orbital myositis

Casasnovas, Núria Meca; Pelluz, Cristina Sangrador; Sotoca, Javier

doi:10.1016/j.jneuroim.2021.577573

Cited by 7 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most studies are case reports or case series. [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] Only one randomized clinical trial has been published, 44 and the remaining reports include a prospective interventional nonrandomized study, 45 2 observational 46,47 an open-label multicenter, 48 and a retrospective longitudinal study. 49 Table 2 shows the 2 comparative studies found.…”

Section: Resultsmentioning

confidence: 99%

“…The most common TCZ regimen found in our review was 8 mg/kg (varying between 4 and 10 mg/kg) administrated IV every 4 weeks. [27][28][29][30][31]33,34,36,38,[40][41][42][43][44][45][47][48][49]60 Regarding the completion of IV treatment, a wide range was observed, from 3 28,29,50,57 to 29 doses, 58 adjusting this number to the clinical improvement. The SC formulation (162 mg) was administrated weekly, 32,37,39,46,48 with a wide variation from 4 weeks to 6 months.…”

Section: Resultsmentioning

confidence: 99%

“…Most of the available results were not statistically analyzed. [27][28][29][30][31][32][33][34][36][37][38][39][40][41][42][43]51,60,61 However, in all studies with statistical analysis, there was a reduction of clinical activity score after treatment with TCZ, with an improvement of at least 3 points. 33,[44][45][46][47][48][49] Likewise, the same improvement was observed in proptosis.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Efficiency and Safety of Tocilizumab for the Treatment of Thyroid Eye Disease: A Systematic Review

Duarte,

Xavier,

Sales Sanz

et al. 2024

Ophthalmic Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Purpose: To review existing literature concerning the effectiveness and safety of tocilizumab (TCZ) for managing thyroid eye disease. Methods: A systematic search was conducted across the PubMed and Embase databases to identify studies on TCZ therapy, from inception to May 2023. The search included the keywords “Graves orbitopathy,” “thyroid ophthalmopathy,” “thyroid eye disease,” “thyroid-associated orbitopathy,” “thyroid-associated ophthalmopathy,” “Graves ophthalmopathy,” “endocrine ophthalmopathy,” and “Tocilizumab.” Only articles written in English, Spanish, or French were considered. Results: Among the 1,013 articles initially screened, a total of 29 fulfilled the eligibility criteria and were selected. Most studies were case reports or case series, and only one randomized clinical trial was found. TCZ has been used mainly in glucocorticoid-resistant or relapsing cases, with a dosage ranging from 4 or 8 mg/kg every 4 weeks when intravenous or a weekly subcutaneous dose of 162 mg. Treatment duration is usually adjusted to the clinical response. TCZ is mostly effective in reducing inflammatory signs during the active phase of thyroid eye disease, with an improvement of at least 3 points in clinical activity score and an overall relapsing rate of 8.2%. Numerous studies have shown marked reductions in proptosis; although the only available randomized controlled trial reported a nonstatistically significant improvement 6 months after treatment, a recent meta-analysis indicated that TCZ seems to be the most effective treatment for reducing proptosis. No severe side effects related to intravenous or subcutaneous TCZ administration were reported. Discussion: Despite these promising findings, randomized clinical trials to directly compare the efficacy and safety of TCZ and other currently available therapeutic options are needed.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Efficiency and Safety of Tocilizumab for the Treatment of Thyroid Eye Disease: A Systematic Review

Duarte,

Xavier,

Sales Sanz

et al. 2024

Ophthalmic Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

show abstract

“…These conflicting results outline the importance of treatment duration as well as the highly complex and heterogeneous entity of NSOI. In fact, in a case of unresponsive orbital myositis to systemic corticosteroid treatment, with subsequent unsatisfying clinical outcomes with immunosuppressants and other biological agents (i.e., infliximab and adalimumab), off-label use of tocilizumab at a starting dose of 8 mg/kg/day in combination with prednisone (60 mg/day) has shown great efficiency in stabilizing the clinical presentation of the disease while being able to further achieve tapering of prednisone following 9 cycles of treatment [180]. However, tocilizumab comes with its own burden of side effects.…”

Section: Interleukin-6 Receptor Binding Agentsmentioning

confidence: 99%

Nonspecific Orbital Inflammation (NSOI): Unraveling the Molecular Pathogenesis, Diagnostic Modalities, and Therapeutic Interventions

Wu,

Kulbay,

Daigle

et al. 2024

IJMS

View full text Add to dashboard Cite

Nonspecific orbital inflammation (NSOI), colloquially known as orbital pseudotumor, sometimes presents a diagnostic and therapeutic challenge in ophthalmology. This review aims to dissect NSOI through a molecular lens, offering a comprehensive overview of its pathogenesis, clinical presentation, diagnostic methods, and management strategies. The article delves into the underpinnings of NSOI, examining immunological and environmental factors alongside intricate molecular mechanisms involving signaling pathways, cytokines, and mediators. Special emphasis is placed on emerging molecular discoveries and approaches, highlighting the significance of understanding molecular mechanisms in NSOI for the development of novel diagnostic and therapeutic tools. Various diagnostic modalities are scrutinized for their utility and limitations. Therapeutic interventions encompass medical treatments with corticosteroids and immunomodulatory agents, all discussed in light of current molecular understanding. More importantly, this review offers a novel molecular perspective on NSOI, dissecting its pathogenesis and management with an emphasis on the latest molecular discoveries. It introduces an integrated approach combining advanced molecular diagnostics with current clinical assessments and explores emerging targeted therapies. By synthesizing these facets, the review aims to inform clinicians and researchers alike, paving the way for molecularly informed, precision-based strategies for managing NSOI.

show abstract

“…Infliximab, a biologic anti-tumor necrosis factor-alpha agent, has anti-inflammatory potential in IOM cases which are severe, recurrent, or recalcitrant to corticosteroids and methotrexate [36]. A cortico-dependent case of IOM was successfully treated with the monoclonal anti-interleukin-6 receptor antibody tocilizumab [37]. In view of their systemic toxicity profile, these drugs are reserved for chronic or recurrent IOM with severe symptomatology.…”

Section: Treatmentmentioning

confidence: 99%

Idiopathic Orbital Myositis Revisited

Mombaerts¹,

McNab

2022

Curr Rheumatol Rep

View full text Add to dashboard Cite

Purpose of ReviewTo review current knowledge regarding idiopathic orbital myositis. Recent Findings Recent publications have focused on possible causes of orbital myositis and the process to reach a diagnosis of idiopathic orbital myositis. With inflamed and enlarged extraocular muscles, features to distinguish between competing diagnostic possibilities are based on imaging in the context of history and clinical signs. Idiopathic orbital myositis is characterized by the clinical triad of acute onset of orbital pain exacerbated on eye movement, double vision, and redness or swelling of the eyelids or conjunctiva, along with the radiological finding of homogeneous, fusiform enlargement of one or more extraocular muscles. In atypical or inconclusive clinico-radiological findings for a diagnosis of idiopathic orbital myositis, or where the clinical behavior changes or fails to respond to corticosteroid treatment, a systemic and oncologic work-up and muscle biopsy are warranted to exclude specific local or systemic disease as cause of the inflamed and enlarged muscle. Summary As our understanding of idiopathic orbital myositis evolves, the diagnostic focus is shifting toward earlier identification of underlying local or systemic disease through systemic work-up and muscle biopsy.

show abstract

Tocilizumab as an alternative for corticosteroid-refractory orbital myositis

Cited by 7 publications

References 15 publications

Efficiency and Safety of Tocilizumab for the Treatment of Thyroid Eye Disease: A Systematic Review

Efficiency and Safety of Tocilizumab for the Treatment of Thyroid Eye Disease: A Systematic Review

Nonspecific Orbital Inflammation (NSOI): Unraveling the Molecular Pathogenesis, Diagnostic Modalities, and Therapeutic Interventions

Idiopathic Orbital Myositis Revisited

Contact Info

Product

Resources

About