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Second-line tocilizumab seen as effective in patients with JIA-associated uveitis
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Tocilizumab therapy was effective in patients with severe juvenile idiopathic arthritis-associated uveitis who previously failed conventional immunosuppressive drugs with at least one anti- tumor necrosis factor agent, according to this study.
The researchers performed a multicenter study of 25 patients with juvenile idiopathic arthritis- associated uveitis who previously failed therapy with conventional immunosuppressive medications and anti-tumor necrosis factor-alpha drugs, which included adalimumab (n = 24), etanercept (n = eight), infliximab (n = seven), abatacept (n = six), rituximab (n = two), anakinra (n = one) and golimumab (n = one). Of the patients, 21 were women and the mean age was 18.5 years. At onset, 22 patients had bilateral uveitis. In addition, 13 patients had cataracts; 12 had band keratopathy; 10 had synechiae; nine had cystoid macular edema (CME); seven had glaucoma and five had amblyopia. Patients received 8 mg of tocilizumab (Actemra, Genentech) every 4 weeks for 6 months. Median follow-up was 12 months.
After therapy, 79.2% of patients showed improvement in anterior chamber cells number, which reached 88.2% at 1 year. Patients with CME showed a decrease in central macular thickness from 401.7 µm to 259.1 µm. At follow-up, 19 patients had complete remission of uveitis. The significant adverse events were severe autoimmune thrombocytopenia, pneumonia followed by autoimmune anemia and thrombocytopenia, viral conjunctivitis and bullous impetigo.
The researchers concluded that tocilizumab appears to be a useful therapy in this patient population. – by Will Offit
Disclosures: One researcher received grant and research support from Abbott, MSD and Roche and received consultation fees or had participation in company-sponsored speaker’s bureau from Abbott, Pfizer, Roche and MSD. Please see the full study for a list of all other researchers’ relevant financial disclosures.
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