Tocilizumab for refractory uveitis associated with juvenile idiopathic arthritis: A report of two cases

J Clin Pharm Ther. 2019 Jun;44(3):482-485. doi: 10.1111/jcpt.12821. Epub 2019 Feb 27.

Abstract

What is known and the objective: Low-grade evidence supports the use of newer biologics for otherwise refractory juvenile idiopathic arthritis (JIA)-associated uveitis, such as tocilizumab.

Case summary: This report details the cases of two adolescents whose severe JIA-associated uveitis was unresponsive to the first-line therapeutic approach. Tocilizumab therapy led to the remission of uveitis after a mean time of 3 weeks, and methotrexate was safely discontinued 1.5 years later.

What is new and conclusion: To our knowledge, these are the first reports of successful methotrexate withdrawal during tocilizumab treatment of JIA-associated uveitis. The administration of tocilizumab without methotrexate could be considered in patients with JIA-associated uveitis unresponsive to conventional therapy.

Keywords: biologics; child; juvenile idiopathic arthritis; refractory; tocilizumab; uveitis.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Juvenile / drug therapy*
  • Child
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Methotrexate / therapeutic use
  • Treatment Outcome
  • Uveitis / drug therapy*

Substances

  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Immunosuppressive Agents
  • tocilizumab
  • Methotrexate