Tocilizumab for the Treatment of Behçet Uveitis that Failed Interferon Alpha and Anti-Tumor Necrosis Factor-Alpha Therapy

Öztürk, Hilal Eser; Oray, Merih; Tuğal-Tutkun, İlknur

doi:10.1080/09273948.2017.1355471

Cited by 51 publications

(20 citation statements)

References 31 publications

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“…This has led to the clinical trials of tocilizumab, with several studies showing its efficacy in improving visual acuity and CME in cases of recalcitrant uveitis, with minimal adverse events associated with therapy . Multiple retrospective case series show similar results of efficacy and safety . A recent multicentre retrospective study on patients with JIA‐associated uveitis (refractory to ≥1 TNF‐α inhibitor) treated with tocilizumab showed that 88.2% of patients had complete control of ocular inflammation at 12 months .…”

Section: Il Blockersmentioning

confidence: 99%

“…[85][86][87][88][89][90][91] Multiple retrospective case series show similar results of efficacy and safety. [92][93][94][95] A recent multicentre retrospective study on patients with JIA-associated uveitis (refractory to ≥1 TNF-α inhibitor) treated with tocilizumab showed that 88.2% of patients had complete control of ocular inflammation at 12 months. 93 There was a significant reduction in concomitant corticosteroid dosage and a statistically significant improvement in CMT and visual acuity.…”

Section: Il Blockers Tocilizumabmentioning

confidence: 99%

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The use of biologic agents in the management of uveitis

Trivedi

Katelaris

2019

Internal Medicine Journal

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The uveitides are a heterogenous group of ocular inflammatory disorders that account for the third highest cause of blindness worldwide, responsible for 5–10% of visual impairment globally. Up to 35% of patients with uveitis can suffer significant vision loss. To prevent irreversible structural damage and blindness, it is important that the diagnosis and commencement of appropriate therapy occurs promptly. Management includes topical and systemic corticosteroid therapy and conventional immunomodulatory agents, including methotrexate, azathioprine, mycophenolate mofetil and cyclosporin. Significant progress has been made in the past decade in our understanding of the immunopathological pathways that drive intraocular inflammation, allowing the development of targeted therapy with biologic agents. These include TNF‐α inhibitors, such as infliximab, adalimumab and etanercept; interleukin blockers, such as tocilizumab and daclizumab; and other targeted therapies, such as rituximab and abatacept. The efficacy of these agents has been studied in cases of severe uveitis that are refractory to conventional immunomodulatory agents and provide exciting results that have revolutionised uveitis management. Though the biologic era has provided a large armamentarium to treat uveitis, ongoing challenges and cases of recalcitrant uveitis remain, posing a challenge to internal medicine physicians. This comprehensive review aims to construct an updated summary on the existing evidence pertaining to the use of biologic agents in the treatment of uveitis. Methods include a systematic search for studies between 2000 and 2018 using PubMed, EMBASE, Ovid MEDLINE and Cochrane libraries.

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Section: Il Blockersmentioning

confidence: 99%

Section: Il Blockers Tocilizumabmentioning

confidence: 99%

The use of biologic agents in the management of uveitis

Trivedi

Katelaris

2019

Internal Medicine Journal

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“…Tocilizumab, an anti-interleukin-6 (IL-6) receptor antibody, was used to treat 5 BU patients resistant to IFN-a and anti-TNF-a therapy, and all of the patients showed both clinical and angiographic improvement as well as a significant reduction in CMT. 99 Another molecule reported to be successful in treating resistant patients is golimumab, which is also an anti-TNF-a agent. It was shown to induce rapid regression of retinal vasculitis and reduce ocular episodes in 5 patients resistant to conventional and other biologic therapies.…”

Section: Introductionmentioning

confidence: 99%

Behçet’s Uveitis: Current Diagnostic and Therapeutic Approach

Özdal¹

2020

tjo

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Behçet’s disease is a chronic, multisystem inflammatory disorder characterized by relapsing inflammation. Although its etiopathogenesis has not yet been clarified, both the adaptive and innate immune systems, genetic predisposition, and environmental factors have all been implicated. It is more frequent and more severe in males in the third and fourth decades of life. The eye is the most frequently involved organ in the course of the disease. Ocular involvement (Behçet’s uveitis) is characterized by bilateral recurrent non-granulomatous panuveitis and occlusive retinal vasculitis. Recurrent inflammatory episodes in the posterior segment may lead to permanent vision loss due to irreversible retinal damage and complications such as macular scarring, macular atrophy, and optic atrophy. Early and aggressive immunomodulatory treatment and the use of biologic agents when needed are crucial for preventing recurrences and improving visual prognosis.

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“…Finally, a clearing pars plana victrecomy may be considered for eyes that are unresponsive to medical therapy--especially when an epiretinal membrane is present and concomitant removal of that membrane may result in further restoration of vision. Six original articles [19][20][21][22][23][24] in this issue of Ocular Immunology & Inflammation address various aspects of the management of UME.…”

mentioning

confidence: 99%

“…Eser Ozturk et al 21 described the use of tocilizumab (TCZ), a fully humanized monoclonal antibody directed against both soluble and membrane-bound interleukin-6 (IL-6) receptor, in five subjects with Behçet uveitis who failed two to five years of treatment with conventional immunosuppression, interferon alpha, and anti-TNF therapy seen at a university center in Istanbul, Turkey. Drug was administered at a dose of 8 mg/kg as monthly intravenous infusion.…”

mentioning

confidence: 99%