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International Ophthalmology

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01.12.2024 | Original Paper

Efficacy of tocilizumab in patients with moderate-to-severe corticosteroid-resistant thyroid eye disease: a prospective study

verfasst von: Chaeyeon Lee, Ji Woong Park, Yoon-Duck Kim, Kyung In Woo

Erschienen in: International Ophthalmology | Ausgabe 1/2024

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Abstract

Purpose

To evaluate the clinical outcomes of intravenous tocilizumab (TCZ) injection in patients with moderate-to-severe active thyroid eye disease (TED).

Methods

Patients with active and moderate-to-severe TED who did not respond to conventional therapies were treated with TCZ from June 2019 to January 2021. The medical records of the patients were evaluated before the treatment. We analyzed patient demographics, including the duration of Graves’ disease and TED, and assessed subjective symptoms, such as diplopia and ocular movement, clinical activity score (CAS), modified NOSPECS score, and exophthalmos before treatment and at 4, 8, 12, and 16 weeks after the first drug injection. Blood tests, including TSH Rc Ab and TS Ab, were performed before treatment and 24 weeks after the first injection. And orbital computed tomography (CT) was performed and Barrett’s Index was calculated at baseline and after completion of all injections.

Results

Nineteen completed the scheduled treatment. There were no significant side effects, other than herpes zoster in one case and headache and dermatitis in another. Clinical symptoms before and 16 weeks after the treatment showed mean CAS decreased by 2.4 points, mean modified NOSPECS score decreased by 3.7 points, and mean exophthalmos decreased by 0.4 mm. Diplopia and extraocular muscle limitation improved in ten and remained stationary in five of the 15 patients, who presented with extraocular motility abnormalities. Six of 11 patients who underwent orbit CT showed improvement in muscle size. The mean TSH Rc Ab decreased by 7.5 IU/L and TS-Ab decreased by 162.9%.

Conclusion

TCZ can treat active moderate-to-severe TED, showing high drug compliance and reasonable response to inflammation and extraocular motility abnormality.

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Titel: Efficacy of tocilizumab in patients with moderate-to-severe corticosteroid-resistant thyroid eye disease: a prospective study
verfasst von: Chaeyeon Lee
Ji Woong Park
Yoon-Duck Kim
Kyung In Woo
Publikationsdatum: 01.12.2024
Verlag: Springer Netherlands
Erschienen in: International Ophthalmology / Ausgabe 1/2024
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-024-03117-6

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Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Efficacy of tocilizumab in patients with moderate-to-severe corticosteroid-resistant thyroid eye disease: a prospective study

Abstract

Purpose

Methods

Results

Conclusion

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Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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