Tocilizumab in a Case of Refractory Idiopathic Orbital Inflammation: 6-Year Follow-Up Outcomes

Artieda, June Artaechevarria; Elias, Ignacio Tapias

doi:10.1159/000508237

Cited by 8 publications

(10 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

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%

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%

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

“…Andere Gruppen berichten über Erfolge mit Azathioprin, Mycophenolat-Mofetil (MMF), Tocilizumab, Rituximab, Infliximab und Adalimumab [266][267][268][269][270][271][272]. Leider ist die Datenlage zu dem Einsatz dieser Medikamenten bei IOI begrenzt und es fehlen prospektive Studien.…”

Section: Biopsieunclassified

“…Smith und Rosenbaum behandelten 57 % der IOI-Patienten erfolgreich mit Methotrexat (15–25 mg pro Woche) 265 . Andere Gruppen berichten über Erfolge mit Azathioprin, Mycophenolat-Mofetil (MMF), Tocilizumab, Rituximab, Infliximab und Ada-limumab 266 267 268 269 270 271 272 . Leider ist die Datenlage zu dem Einsatz dieser Medikamenten bei IOI begrenzt und es fehlen prospektive Studien.…”

Section: Orbitale Autoimmunerkrankungenunclassified

Interdisziplinäre Therapie der Erkrankungen der Orbita

Eckstein,

Welkoborsky

2024

Laryngorhinootologie

View full text Add to dashboard Cite

ZusammenfassungDie Diagnostik und Therapie von Erkrankungen der Orbita ist eine interdisziplinäre Aufgabe, an der u.a. die Fachdisziplinen HNO-Heilkunde, Augenheilkunde, Radiologie, Strahlentherapie, MKG-Chirurgie, Endokrinologie und Pädiatrie beteiligt sind. Der vorliegende Übersichtsartikel stellt eine Zusammenstellung der häufigsten Erkrankungen dar, mit denen die Fachdisziplinen HNO-Heilkunde und Augenheilkunde interdisziplinär befasst sind. Es werden die akuten entzündlichen Erkrankungen incl. orbitaler Komplikationen, die autoimmunologischen Erkrankungen der Orbita incl. der endokrinen Orbitopathie, und die tumorösen Erkrankungen besprochen. Neben der Diagnostik und der Beschreibung der Klinik wird besonderes Augenmerk auf die interdisziplinäre Therapie gelegt. Abgerundet wird der Übersichtsartikel mit der Beschreibung der wichtigsten chirurgischen Zugangswege zur Orbita, ihre Indikationen und mögliche Komplikationen. Die Autoren haben versucht, trotz der knappen Darstellung die relevanten Fakten zu beschreiben.

show abstract

“…Tocilizumab is a humanized monoclonal IgG1 antibody that inhibits the molecular actions of IL-6 by binding to its receptor (i.e., IL6R)-either the soluble or membrane-bound receptor [176,177]. Tocilizumab was shown to prevent the recurrence of NSOI in a 59-year-old patient with refractory NSOI over a span of 6 years when used at a maintenance dose of 4 mg/kg and following an initial treatment at a dose of 8 mg/kg [178]. However, in another case report, it was demonstrated that an initiation dose of 4 mg followed by 8 mg every 4 weeks to treat orbital pseudotumor couldn't achieve inflammation control at 9 months [179].…”

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

Tocilizumab in a Case of Refractory Idiopathic Orbital Inflammation: 6-Year Follow-Up Outcomes

Cited by 8 publications

References 13 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

Interdisziplinäre Therapie der Erkrankungen der Orbita

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

Contact Info

Product

Resources

About