Tocilizumab for the Management of Corticosteroid-Resistant Mild to Severe Graves’ Ophthalmopathy, a Report of Three Cases

ABSTRACT

Purpose: To discuss the use of tocilizumab in mild to severe Graves’ ophthalmopathy as corticosteroid-adjunctive therapy.

Methods: Retrospective case reports.

Results: Three patients with corticosteroid-resistant or advanced diplopia-associated Graves’ ophthalmopathy were subsequently treated with monthly intravenous tocilizumab at a dose of 8 mg/kg. None reported a past or present history of dysthyroidism. The adjunction of interleukin-6-receptor monoclonal antibody treatment was associated with a significant improvement in ocular symptoms, notably diplopia and proptosis, and functional prognosis in all patients, with one relapse approximately two months after the end of the treatment.

Conclusion: These clinical reports confirm the relative efficacy and tolerability profile of intravenous tocilizumab in severe or corticosteroid-resistant Graves’ ophthalmopathy.

Keywords:

• Biotherapies
• EUGOGO
• Graves’ ophthalmopathy
• proptosis
• tocilizumab

Acknowledgments

The authors thank Suzanne Rankin for proofreading the article.

Disclosure Statement

The authors declare no conflicts of interest and are responsible for the content and writing of the paper.