Abstract Listings 2024

Purpose

To evaluate subcutaneous tocilizumab’s efficacy and safety in thyroid eye disease (TED) patients resistant or intolerant to corticosteroids.

Methods

Retrospective analysis of patients treated with subcutaneous tocilizumab (SC TCZ) due to resistance, intolerance, or maximum safe dosage of corticosteroids (GC). Data on demographics, clinical characteristics, and outcomes were collected. SC TCZ was administered weekly (167mg) until achieving disease control. Adverse events and clinical outcomes, including Clinical Activity Score (CAS), exophthalmometry, upper eyelid margin-reflex-distance (MRD1), Thyrotropin Receptor Antibody (TRAB) levels, and ocular motility, were assessed.

Results

A total of 18 patients were included in the study, with an average age of 53.2 years. A majority of 72.2% were female. The most common indication for SC TCZ was resistance to GC (88.9%). Seven patients had undergone previous orbital surgery (POS), and their outcomes were analysed separately from the remaining group of 9 patients (18 eyes). The mean duration of SC TCZ treatment was 6.4 months. Fatigue was the most common adverse event (5.6%). Disease recurrence occurred in 11.8% of cases. Two patients (11.1%) experienced disease progression during TCZ treatment. Within the POS group, one patient (14.3%) experienced disease progression while on TCZ. In the primary cohort comprising 18 eyes, significant improvements were observed in disease metrics such as CAS, exophthalmometry, MRD1, diplopia and TRAB levels, from baseline to 6 months post-treatment, which were maintained at the 12-month follow-up.

Conclusion

These findings indicate that SC TCZ can be a viable treatment alternative for steroid-resistant TED. This potential extends to patients who have undergone orbital decompression for sight-threatening active disease, highlighting the versatility and therapeutic promise of SC TCZ in managing challenging cases of TED.

Additional Authors

↑ Back to top