The Role of Monoclonal Antibodies Targeting IL-6–Mediated Signalling Pathways in the Treatment of Thyroid Eye Disease
Author: Daniel Ezra
Base Hospital / Institution: Ophthalmology, Oculoplastic Surgery, Moorfields Eye Hospital and University College London
ePoster presentation
Abstract ID: 25-432
Purpose
Thyroid eye disease (TED) is a debilitating, disfiguring, and potentially vision-threatening autoimmune disorder characterised by orbital inflammation and fibrosis. The central role of interleukin-6 (IL-6)-mediated signalling in TED pathogenesis has prompted interest in the therapeutic potential of monoclonal antibodies (mAbs) targeting IL-6 and its receptor (IL-6R).
Methods
We provide a comprehensive overview of published clinical efficacy and safety data supporting the use of anti–IL-6/IL-6R mAbs in the treatment of TED, and their potential benefits and limitations compared with current treatment options.
Results
Clinical studies have shown that in individuals with active, moderate-to-severe TED, off-label treatment with the anti–IL-6R mAb tocilizumab can significantly reduce disease activity and titres of thyroid-stimulating autoantibodies (a key trigger for TED), as well as improve quality of life, proptosis, and possibly diplopia. Compared with currently available treatments, tocilizumab has been associated with fewer adverse events and a lower risk of relapse following discontinuation. Importantly, the availability of subcutaneous administration with tocilizumab reduces treatment burden, a benefit that may be further enhanced by the next generation of long-acting anti–IL-6/IL-6R mAbs such as satralizumab and pacibekitug; however, further studies are needed to confirm their efficacy and safety in TED.
Conclusion
For individuals with TED, mAbs targeting IL-6–mediated signalling pathways offer a promising strategy for disease management, combining clinical efficacy with improved tolerability and reduced treatment burden.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Atsushi | Azumi | Ophthalmology Department and Eye Center, Kobe Kaisei Hospital, Kobe, Hyogo, Japan |
| César A. | Briceño | Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA |
| Fatemeh | Rajaii | Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA |
| Mario | Salvi | Endocrinology Unit, Graves’ Orbitopathy Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy |
| Marco | Sales-Sanz | Department of Ophthalmology, Hospital Universitario Ramon y Cajal, Madrid, Spain; IMO Madrid, Grupo Miranza, Madrid, Spain |
| Laura | Brockwell | Roche Products Ltd., Welwyn Garden City, UK |
| Oluwatobi | Idowu | Genentech, Inc., South San Francisco, CA, USA |
