Tocilizumab for the Treatment of Behçet Uveitis that Failed Interferon Alpha and Anti-Tumor Necrosis Factor-Alpha Therapy

Ocul Immunol Inflamm. 2018;26(7):1005-1014. doi: 10.1080/09273948.2017.1355471. Epub 2017 Oct 11.

Abstract

Purpose: To report the results of tocilizumab (TCZ) treatment in patients with Behçet uveitis (BU) who had failed conventional, interferon alpha, and anti-Tumor necrosis factor-alpha therapy.

Methods: We reviewed the records of five patients with BU treated with monthly infusions of TCZ 8 mg/kg. Outcome measures were visual acuity, anterior chamber cells, laser flare meter (LFM) readings, vitreous haze, central macular thickness (CMT), and fluorescein angiography (FA) score.

Results: The clinical inactivity of BU and 20/50 or better vision were achieved in three female and two male patients treated with TCZ for 5-19 months. The mean LFM reading was reduced from 15.4 ± 2.7 to 5.0 ± 0.9 ph/ms; the mean CMT from 324.7 ± 36.6 µm to 280.2 ± 34.1 µm; and the mean FA score from 20.6 ± 5.4 to 9.3 ± 4.5 µm at the last visit. The only side effect was a slight elevation of the total cholesterol level in one patient.

Conclusions: Tocilizumab may be a safe and effective therapeutic option for refractory BU.

Keywords: Behçet uveitis; central macular thickness; fluorescein angiography score; laser flare; tocilizumab.

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Behcet Syndrome / drug therapy*
  • Female
  • Fluorescein Angiography
  • Humans
  • Immunotherapy / methods*
  • Interferon-alpha / therapeutic use*
  • Macula Lutea / pathology
  • Male
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Failure
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Tumor Necrosis Factor-alpha / therapeutic use*
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Antibodies, Monoclonal, Humanized
  • Interferon-alpha
  • Tumor Necrosis Factor-alpha
  • tocilizumab