Evidence for Tocilizumab as a Treatment Option in Refractory Uveitis Associated with Juvenile Idiopathic Arthritis.
Journal article

Evidence for Tocilizumab as a Treatment Option in Refractory Uveitis Associated with Juvenile Idiopathic Arthritis.

  • Tappeiner C From the Department of Ophthalmology, St. Franziskus Hospital, Münster; Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg; University of Duisburg-Essen, Essen, Germany; Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Institut Clinic d'Oftalmologia, Hospital Clínic de Barcelona, University of Barcelona; Pediatric Rheumatology Unit, and Ophthalmology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; Department of Paediatric Rheumatology, Bristol Royal Hospital for Children; Clinical Research Unit, Bristol Eye Hospital, Bristol, UK; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands. christoph.tappeiner@insel.ch.
  • Mesquida M From the Department of Ophthalmology, St. Franziskus Hospital, Münster; Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg; University of Duisburg-Essen, Essen, Germany; Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Institut Clinic d'Oftalmologia, Hospital Clínic de Barcelona, University of Barcelona; Pediatric Rheumatology Unit, and Ophthalmology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; Department of Paediatric Rheumatology, Bristol Royal Hospital for Children; Clinical Research Unit, Bristol Eye Hospital, Bristol, UK; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Adán A From the Department of Ophthalmology, St. Franziskus Hospital, Münster; Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg; University of Duisburg-Essen, Essen, Germany; Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Institut Clinic d'Oftalmologia, Hospital Clínic de Barcelona, University of Barcelona; Pediatric Rheumatology Unit, and Ophthalmology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; Department of Paediatric Rheumatology, Bristol Royal Hospital for Children; Clinical Research Unit, Bristol Eye Hospital, Bristol, UK; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Anton J From the Department of Ophthalmology, St. Franziskus Hospital, Münster; Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg; University of Duisburg-Essen, Essen, Germany; Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Institut Clinic d'Oftalmologia, Hospital Clínic de Barcelona, University of Barcelona; Pediatric Rheumatology Unit, and Ophthalmology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; Department of Paediatric Rheumatology, Bristol Royal Hospital for Children; Clinical Research Unit, Bristol Eye Hospital, Bristol, UK; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Ramanan AV From the Department of Ophthalmology, St. Franziskus Hospital, Münster; Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg; University of Duisburg-Essen, Essen, Germany; Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Institut Clinic d'Oftalmologia, Hospital Clínic de Barcelona, University of Barcelona; Pediatric Rheumatology Unit, and Ophthalmology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; Department of Paediatric Rheumatology, Bristol Royal Hospital for Children; Clinical Research Unit, Bristol Eye Hospital, Bristol, UK; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Carreno E From the Department of Ophthalmology, St. Franziskus Hospital, Münster; Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg; University of Duisburg-Essen, Essen, Germany; Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Institut Clinic d'Oftalmologia, Hospital Clínic de Barcelona, University of Barcelona; Pediatric Rheumatology Unit, and Ophthalmology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; Department of Paediatric Rheumatology, Bristol Royal Hospital for Children; Clinical Research Unit, Bristol Eye Hospital, Bristol, UK; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Mackensen F From the Department of Ophthalmology, St. Franziskus Hospital, Münster; Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg; University of Duisburg-Essen, Essen, Germany; Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Institut Clinic d'Oftalmologia, Hospital Clínic de Barcelona, University of Barcelona; Pediatric Rheumatology Unit, and Ophthalmology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; Department of Paediatric Rheumatology, Bristol Royal Hospital for Children; Clinical Research Unit, Bristol Eye Hospital, Bristol, UK; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Kotaniemi K From the Department of Ophthalmology, St. Franziskus Hospital, Münster; Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg; University of Duisburg-Essen, Essen, Germany; Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Institut Clinic d'Oftalmologia, Hospital Clínic de Barcelona, University of Barcelona; Pediatric Rheumatology Unit, and Ophthalmology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; Department of Paediatric Rheumatology, Bristol Royal Hospital for Children; Clinical Research Unit, Bristol Eye Hospital, Bristol, UK; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • de Boer JH From the Department of Ophthalmology, St. Franziskus Hospital, Münster; Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg; University of Duisburg-Essen, Essen, Germany; Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Institut Clinic d'Oftalmologia, Hospital Clínic de Barcelona, University of Barcelona; Pediatric Rheumatology Unit, and Ophthalmology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; Department of Paediatric Rheumatology, Bristol Royal Hospital for Children; Clinical Research Unit, Bristol Eye Hospital, Bristol, UK; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Bou R From the Department of Ophthalmology, St. Franziskus Hospital, Münster; Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg; University of Duisburg-Essen, Essen, Germany; Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Institut Clinic d'Oftalmologia, Hospital Clínic de Barcelona, University of Barcelona; Pediatric Rheumatology Unit, and Ophthalmology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; Department of Paediatric Rheumatology, Bristol Royal Hospital for Children; Clinical Research Unit, Bristol Eye Hospital, Bristol, UK; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • de Vicuña CG From the Department of Ophthalmology, St. Franziskus Hospital, Münster; Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg; University of Duisburg-Essen, Essen, Germany; Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Institut Clinic d'Oftalmologia, Hospital Clínic de Barcelona, University of Barcelona; Pediatric Rheumatology Unit, and Ophthalmology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; Department of Paediatric Rheumatology, Bristol Royal Hospital for Children; Clinical Research Unit, Bristol Eye Hospital, Bristol, UK; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Heiligenhaus A From the Department of Ophthalmology, St. Franziskus Hospital, Münster; Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg; University of Duisburg-Essen, Essen, Germany; Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Institut Clinic d'Oftalmologia, Hospital Clínic de Barcelona, University of Barcelona; Pediatric Rheumatology Unit, and Ophthalmology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; Department of Paediatric Rheumatology, Bristol Royal Hospital for Children; Clinical Research Unit, Bristol Eye Hospital, Bristol, UK; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.
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  • 2016-09-17
Published in:
  • The Journal of rheumatology. - 2016
English OBJECTIVE
To report on experience using the anti-interleukin 6 receptor antibody tocilizumab (TCZ) to treat severe and therapy-refractory uveitis associated with juvenile idiopathic arthritis (JIA).


METHODS
Retrospective data were gathered from patients with JIA receiving TCZ treatment for uveitis. JIA and related uveitis data (disease onset, activity, structural complications, and topical and systemic antiinflammatory treatment) were evaluated at the start of TCZ (baseline) and every 3 months during TCZ therapy.


RESULTS
A total of 17 patients (14 women) with active uveitis were included (mean age 15.3 ± 6.9 yrs, mean followup time 8.5 mos). In all patients, uveitis had been refractory to previous topical and systemic corticosteroids, methotrexate (MTX), and other synthetic and biological disease-modifying antirheumatic drugs, including ≥ 1 tumor necrosis factor-α (TNF-α) inhibitor. Uveitis inactivity was achieved in 10 patients after a mean of 5.7 months of TCZ treatment (in 3 of them, it recurred during followup) and persisted in the remaining 7 patients. By using TCZ, systemic corticosteroids or immunosuppressives could be spared in 7 patients. Macular edema was present in 5 patients at baseline and improved in all of them under TCZ treatment. Arthritis was active in 11 patients at the initial and in 6 at the final followup visit.


CONCLUSION
TCZ appears to represent a therapeutic option for severe JIA-associated uveitis that has been refractory to MTX and TNF-α inhibitors in selected patients. The present data indicate that inflammatory macular edema responds well to TCZ in patients with JIA-associated uveitis.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/107160
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