Outcome of tocilizumab treatment in corticosteroid-resistant thyroid eye disease

Abstract

Introduction: Thyroid eye disease (TED) is a complex and incompletely understood rare autoimmune disorder.

Objectives: To analyze the experience and the outcomes obtained with the use of intravenous tocilizumab in the treatment of TED.

Methods: A retrospective analysis of adult patients diagnosed with active TED resistant to intravenous corticosteroids treated in a tertiary hospital between May 2012 and May 2021.

Results: Eleven patients were included with a mean age of 52±12 (range 35-67) years. Nine patients were female and two were male. Patients received a median of 5±3.2 doses. Twenty out of twenty-four eyes achieved inactivation of TED at week 16. Proptosis response was achieved in 6/8 patients and diplopia response in 3/8 patients. The GO-QOL questionnaire showed clinically significant improvement in 9/11 patients. No serious adverse effects were reported during tocilizumab treatment. One patient required decompressive surgery 15 months after tocilizumab therapy.

Conclusion: The results obtained show that the use of tocilizumab in the treatment of this pathology can be a good alternative.

Keywords: Anticuerpos antirreceptor de TSH; Corticosteroids; Glucocorticoides; Gravesʹ ophthalmopathy; Interleukin 6; Interlucina 6; Oftalmopatía de Graves; Thyroid-stimulating antibodies; Tocilizumab.