Tocilizumab Highly Effective in Refractory Juvenile Idiopathic Arthritis-associated Uveitis

HealthDay News — For patients with juvenile idiopathic arthritis (JIA)-associated uveitis refractory to anti-tumor necrosis factor (TNF) therapy, tocilizumab (TCZ) is beneficial, yielding improvement in all ocular parameters, according to a study published in Arthritis & Rheumatology.

Vanesa Calvo-Río, MD, PhD, from the Hospital Universitario Marqués de Valdecilla in Santander, Spain, and colleagues conducted a multicenter trial involving 25 patients with JIA-associated uveitis that was refractory to conventional immunosuppressive drugs and anti-TNF agents. In 22 of the patients, uveitis was bilateral, with 47 affected eyes.

The researchers found that in most cases, patients received 8 mg/kg TCZ intravenously every 4 weeks. Rapid and maintained improvement in all ocular parameters was seen with TCZ treatment

Overall, 79.2% and 88.2% of patients showed improvement in anterior chamber cell number after 6 months and 1 year, respectively. In patients with cystoid macular edema, there was a decrease in central macular thickness measured by optical coherence tomography from a mean of 401.7 ± 86.8 µm to 259.1 ± 39.5 µm after 6 months of TCZ (=.012). There was an increase in the best corrected visual acuity from 0.56 ± 0.35 to 0.64 ± 0.32 (<.01). Visual improvement persisted after a median follow-up of 12 months, and complete remission of uveitis was seen in 19 of 25 patients.

“TCZ appears to be a useful therapy for severe refractory JIA-associated uveitis,” the researchers wrote.

Two authors disclosed financial ties to the pharmaceutical industry.

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Calvo-Rio V, Santos-Gomez M, Calvo I, et al. Anti-interleukin-6 receptor tocilizumab for severe juvenile idiopathic arthritis-associated uveitis refractory to anti-tumor necrosis factor therapy: a multicenter study of twenty-five patients [published online February 27, 2017]. Arthritis Rheumatol. doi:10.1002/art.39940