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Tocilizumab in glucocorticoid-resistant graves orbitopathy. A case series report of a mexican population

2020; Elsevier BV; Volume: 81; Issue: 2-3 Linguagem: Inglês

10.1016/j.ando.2020.01.003

2213-3941

José Juan Ceballos-Macías, Raúl Rivera-Moscoso, Alberto Flores-Real Jorge, Joel Vargas-Sánchez, Guillermo Ortega-Gutiérrez, Ramón Madriz-Prado, P. Velasco-Ramos, Eloy Muñoz-Monroy Omar, Carolina Meneses-Pérez Anna, Nancy Fernández-Morales Irma, Alfredo Hernández-Moreno,

Advanced Differential Geometry Research

To describe pre- to post-treatment changes in clinical activity score (CAS) and exophthalmometry in patients with Graves orbitopathy treated with tocilizumab (TCZ).Eight Mexican patients presenting with active Graves orbitopathy (CAS>3/7) previously treated with glucocorticoids received 1 monthly dose of TCZ for 6 months. CAS, EUGOGO severity assessment and exophthalmometry were used to evaluate clinical status, with serum measurement of thyroid-stimulating hormone receptor antibodies (TR-Ab) for biochemical evaluation before and after application of TCZ.Eight patients were analyzed: 6 male (75%), 2 female (25%): mean age, 45.9±11.2 years; mean weight, 85±18.3 kg. Mean TR-Ab level at treatment outset was 291.9±96.4%, mean CAS 4.1±0.3 and mean exophthalmometry 21.2±3.2 mm. After TCZ treatment, mean TR-Ab level fell to 172.7±54% (P=0.001), mean CAS to 1.1±0.6 (P=0.001) and mean exophthalmometry to 19.3±2 mm (P=0.02).TCZ is a therapeutic option for glucocorticoid-resistant orbitopathy, and should be considered in second line due to the cost of treatment or in first line in patients with contraindications to intravenous GC pulse therapy.