SAT0520 Anti-il6-receptor tocilizumab in refractory uveitis associated to extraocular manifestations in patients with behÇet’s disease. multicenter study of 11 patients

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 1115
• Main Authors: Atienza-Mateo, B., Martín-Varillas, J.L., Calvo-Río, V., Beltrán, E., Martinez, L., Valls, E., Hernandez, M., Atanes, A., Cordero, M., Nolla, J.M., Carrasco, C., Loricera, J., Palmou-Fontana, N., Pons, E., González-Vela, M.C., Demetrio-Pablo, R., González-Gay, M.A., Blanco, R.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Arthritis; Behcet's syndrome; Corticosteroids; Drugs; Edema; Epidemiology; Erythema; Erythema nodosum; Etanercept; Folliculitis; Immunosuppressive agents; Infliximab; Interleukin 6; Intestine; Literature reviews; Magnetic resonance imaging; Monoclonal antibodies; NMR; Nuclear magnetic resonance; Patients; Remission; Retina; Tumor necrosis factor-α; Ulcers; Uveitis; Vasculitis; Vein & artery diseases
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.4093

ObjectivesTo assess the efficacy of Tocilizumab (TCZ) in refractory uveitis associated to extraocular manifestations due to Behçet’s disease (BD).MethodsMulticenter study of patients with BD refractory to standard systemic treatment (conventional immunosuppressive drugs and/or anti-TNF-α agents).ResultsWe studied 11 patients (7 men/4 women) (20 affected eyes); mean age 38.4±20.4 years. Uveitis was bilateral in 9 patients. The pattern of ocular involvement was: panuveitis (n=8; with retinal vasculitis in 4), anterior uveitis (n=2) and posterior uveitis (n=1). Cystoid macular oedema (CME) was present in 7 patients. The clinical course was recurrent (n=7) or chronic (n=4). Apart from the visual complications, at TCZ onset the following extraocular manifestations were present: oral and/or genital ulcers (n=7), arthritis (n=4), folliculitis/pseudofolliculitis (n=4), erythema nodosum (n=2), livedo reticularis (n=1), intestinal affection (n=1), and neurological involvement (n=2).Before TCZ, they had received systemic corticosteroids, conventional immunosuppressive drugs and biologic agents, adalimumab (n=8), infliximab (n=4), golimumab (n=3), canakinumab (n=1), or etanercept (n=1). TCZ was used in monotherapy or combined with conventional immunosuppressive drugs at 8 mg/kg/iv/4 weeks (n=10) or 162 mg/sc/week (n=1). TCZ yielded rapid and maintained improvement in all ocular parameters (TABLE). After a mean follow-up of 9.5±8.05 months using TCZ, all patients experienced ocular improvement, with complete remission in 8 of them. However, TCZ was only effective in 3 of the patients with extraocular manifestations. This biologic agent had to be withdrawn in 2 cases, 1 due to a severe infusion reaction and 1 due to arthritis impairment.Abstract SAT0520 – Table 1Epidemiological and clinical characteristic of the sample.Abbreviations: CME, cystoid macular oedema; MRI, magnetic resonance imaging; TCZ, tocilizumab.ConclusionsTCZ appears to be useful in highly refractory BD-related uveitis. However, there are controversial results regarding its efficacy in the treatment of extraocular manifestations of BD.References[1] Santos-Gómez M, Calvo-Río V, Blanco R, Beltrán E, Mesquida M, Adán A. The effect of biologic therapy different from infliximab or adalimumab in patients with refractory uveitis due to Behcet’s disease: results of a multicenter open label study. Clin Exp Rheumatol2016;34(6Suppl 102):S34–S40.[2] Calvo-Río V, de la Hera D, Beltran-Catalan E, Blanco R, Hernandez M., Martinez-Costa L. Tocilizumab in uveitis refractory to other biologic drugs: a study of 3 cases and a literature review. Clin Exp Rheumatol2014;32(Suppl 84):S54–S57.[3] Calvo-Río V, Santos-Gomez M, Calvo I, et al. Anti-IL6-R Tocilizumab for Severe Juvenile Idiopathic Arthritis-Associated Uveitis Refractory to anti-TNF therapy. A multicenter study of 25 patients. Arthritis Rheumatol2016;69:668–75.Disclosure of InterestNone declared