Abstract ID: 26-505
Clinical Outcomes of Tocilizumab for Active Thyroid Eye Disease: A Multicenter Retrospective Analysis
Author: Catarina Barão Base Hospital / Institution: ULS São José
Presentation Type: ePoster Presentation
Purpose
To evaluate the efficacy and safety of tocilizumab (TCZ) in patients with moderate-to-severe thyroid eye disease (TED) and to assess the durability of treatment response over 12 months.
Methods
A multicenter retrospective study was conducted at Hospital de São José and Hospital CUF Descobertas. Thirty-five patients with active TED treated with TCZ were identified; 25 were included after excluding patients with insufficient data, ongoing treatment, or inadequate follow-up. Outcomes were assessed at baseline, treatment completion, and 6- and 12-month follow-up. Evaluated parameters included CAS, TRAb, proptosis, lid retraction, diplopia, recurrence, and adverse events.
Results
The cohort included 17 women (68%) with a mean age of 51.7 years. All patients had previously received intravenous corticosteroids. TCZ was initiated mainly because of corticosteroid resistance or disease recurrence (83.3%). Mean CAS improved from 3.3 at baseline to 0.6 at treatment completion and 0.1 at 6 months (p<0.05). TRAb decreased from 34.1 IU/L to 18.6 IU/L at treatment completion and 5.3 IU/L at 6 months. Mean proptosis improved from 22.9 mm to 21.0 mm at 6 months, with 58% of eyes achieving a reduction ≥2 mm. Among patients with diplopia at baseline (n=9), 77.8% improved and 44.4% achieved complete resolution by 6 months, with no worsening cases. Improvements were maintained at 12 months. Recurrence occurred in 3 patients (8.7%), while disease progression under TCZ was observed in 4 patients (11.4%). Adverse events were mild, mainly hypercholesterolemia (14.3%) and neutropenia (5.7%).
Conclusion
TCZ appears to be an effective and well-tolerated treatment for moderate-to-severe TED, providing sustained improvement in inflammatory activity, proptosis, and diplopia, with durable benefits maintained at 1 year.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Joana | Ferreira | ULS São José |
| Patrícia | Barros Silva | ULS São José |
| Catarina | Mota | ULS São José |
| Sofia | Pinheiro | ULS São José |
| Ana | Magriço | ULS São José |
| Ana | Duarte | H. CUF Descobertas |