A study has assessed the safety and efficacy of Tocilizumab ( Actemra; RoActemra ) in patients with severe and refractory non-infectious uveitis.
Eight consecutive unselected patients with severe and refractory non-infectious uveitis [ Birdshot chorioretinopathy ( n=1 ), Behçet's disease ( n=1 ) and idiopathic bilateral panuveitis ( n=6 ) ] treated with Tocilizumab ( 8mg/kg every 4 weeks intravenously ) were included.
The primary outcome was the response to treatment, defined by decrease of inflammatory ocular signs.
Four ( 50% ) patients were of female gender and the median ( IQR ) age was 41 years. The median number of previous immunosupressants was of 5.5.
Seven patients had been previously treated with anti-TNF-alpha [ Infliximab ( n=5 ) and Adalimumab ( n=2 ) ].
The immunosupressive drugs used in association with Tocilizumab were Azathioprine ( n=2 ), Mycophenolate mofetil ( n=2 ) and Methotrexate ( n=2 ).
After a median follow-up of 8 months, 6/8 ( 75% ) improved under Tocilizumab and 2 ( 25% ) were non-responders. The visual acuity improved in five patients.
The median dose of Prednisolone decreased from 16mg/day to 10 mg/day, at baseline and at the end of follow-up, respectively.
Tolerance of Tocilizumab was satisfactory and side effects included bronchitis ( n=1 ) and grade 1 leukopenia ( n=1 ) and thrombocytopenia ( n=1 ).
In conclusion, Tocilizumab seems to be a safe and promising therapy in severe and refractory non-infectious uveitis. ( Xagena )
Papo M et al, Clin Exp Rheumatol 2014;32 Suppl 84(4):75-79