Tocilizumab Employment in the Treatment of Resistant Juvenile Idiopathic Arthritis Associated Uveitis

ABSTRACT

Aim

To determine the efficacy and safety of intravenous tocilizumab in refractory juvenile idiopathic arthritis associated uveitis.

Patients and Methods

This was a retrospective observational case series. Patients with refractory juvenile idiopathic arthritis associated uveitis, who had received tocilizumab were included in this study.

Results

8 patients (14 eyes) were included in this study. The average age of the patients at the first visit was 16.8 ± 11.2 years (7–40). The average duration of follow-up period after starting treatment was 28.6 ± 24.6 months (9–70). Intravenous tocilizumab infusions induced and maintained remission in 5 patients (8 eyes). Vasculitis was resolved within 8 months in all but one patient. The presence of papillitis before starting treatment was directly correlated with visual acuity improvement. No side effects were observed.

Conclusion

Intravenous tocilizumab infusion can be an effective and safe method of treatment to induce and maintain remission in resistant juvenile idiopathic arthritis associated uveitis.

KEYWORDS:

• Biologic response modifiers
• immunomodulatory therapy
• juvenile idiopathic arthritis
• tocilizumab

Acknowledgments

Financial supports: None

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Dr. C Stephen Foster declares the following:

Consultancies with Aldeyra Therapeutics (Lexington, MA), Allakos (Redwood City, CA), Bausch & Lomb Surgical, Inc (Rancho Cucamonga, CA), Eyegate Pharma (Waltham, MA), Genentech (South San Francisco, CA), Novartis (Cambridge, MA), pSivida (Watertown, MA)

Grants or grants pending with Aciont (Salt Lake City, UT), Alcon (Aliso Viejo, CA), Aldeyra Therapeutics (Lexington, MA), Bausch & Lomb (Rochester, NY), Clearside Biomedical (Alpharetta, GA), Dompé pharmaceutical (Milan, Italy), Eyegate Pharma (Waltham, MA), Mallinckrodt pharmaceuticals (Staines-upon-Thames, UK), Novartis Pharmaceuticals (Cambridge, MA), pSivida (Watertown, MA), Santen (Osaka, Japan).

Payment for lectures including service on speaking bureaus: Alcon (Aliso Viejo, CA), Allergan (Dublin, Ireland), Mallinckrodt pharmaceuticals (Staines-upon-Thames, UK).

Stock or Stock Options: Eyegate Pharma (Waltham, MA)

Dr. Stephen D. Anesi declares the following:Consultancies with Santen (Osaka, Japan), Mallinckrodt (Staines-upon-Thames, UK), Allakos (Redwood City, CA), Eyepoint (Watertown, MA), and Takeda (Tokyo, Japan). Speakerships with AbbVie (Chicago, IL), Mallinckrodt (Staines-upon-Thames, UK), and Eyepoint (Watertown, MA). Dr. Peter Chang declares the following: Consultancies with Eyepoint (Watertown, MA) and Alimera (Alpharetta, GA). Speakerships with AbbVie (Chicago, IL), Mallinckrodt (Staines-upon-Thames, UK), and Eyepoint (Watertown, MA).

Conflict of Interest

No conflicting relationship exists for any author.

Compliance with ethics guidelines

This study was approved by the New England Institutional Review Board, which has issued a waiver of informed consent for the retrospective chart review analysis.

This study was performed in accordance with the Helsinki Declaration of 1964, and its later amendments.

All participants provided consent for publication if any identifying information is included in the manuscript.

Data Availability

The data that support the findings of this study are available from the corresponding author, Stephen D. Anesi, upon reasonable request.

Declaration of interest

The authors report no conflicts of interest.