The role of tocilizumab in the treatment of inflammatory diseases of the eye and orbit: A useful alternative

Ruiz‐Medrano, Jorge; Díaz-Valle, D.; Cuiña, R.; Gegúndez, José A; Chhablani, Jay; Majumder, Parthopratim Dutta; Gutierrez-Bonet, R.

doi:10.1016/j.jfo.2018.02.006

Cited by 13 publications

(8 citation statements)

References 56 publications

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“…These findings apply to chronic consolidated tocilizumab uses organ disorders [17][18][19] ), unpredictable AEs were also retrieved, namely DILI and acute pancreatitis, though expected from postmarketing experience.…”

Section: Discussionmentioning

confidence: 72%

“…Although most DMEs showing statistical disproportionality were classified as expected (namely anaphylactic reaction/shock, intestinal perforation and pancytopenia 16 ) or disease‐related (namely renal failure, pulmonary hypertension and fibrosis, sensory organ disorders 17–19 ), unpredictable AEs were also retrieved, namely DILI and acute pancreatitis, though expected from post‐marketing experience.…”

Section: Discussionmentioning

confidence: 99%

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Serious adverse events with tocilizumab: Pharmacovigilance as an aid to prioritize monitoring in COVID‐19

Gatti

Fusaroli

Caraceni

et al. 2020

Brit J Clinical Pharma

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Given its approval for the treatment of cytokine release syndrome, tocilizumab is under investigation in severe coronavirus disease-2019. To characterize serious adverse events (AEs) with tocilizumab, we queried the worldwide FDA Adverse Event Reporting System and performed disproportionality analysis, selecting only designated medical events (DMEs) where tocilizumab was reported as suspect, with a focus on hepatic reactions. The reporting odds ratios (RORs) were calculated, deemed significant by a lower limit of the 95% confidence interval (LL 95% CI) > 1. A total of 2,433 reports of DMEs were recorded with tocilizumab, mainly in rheumatic diseases. Statistically significant RORs emerged for 13 DMEs, with drug-induced liver injury (n = 91; LL 95% CI 3.07), pancreatitis (151; 1.41), and pulmonary fibrosis (222; 7.21) as unpredictable AEs. A total of 174 cases of liver-related DMEs were retrieved (proportion of deaths = 18.4%), with median onset of 27.5 days. These serious unpredictable reactions occurring in chronic real-world tocilizumab use may support patient care and monitoring of ongoing clinical trials.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Serious adverse events with tocilizumab: Pharmacovigilance as an aid to prioritize monitoring in COVID‐19

Gatti

Fusaroli

Caraceni

et al. 2020

Brit J Clinical Pharma

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“…With regard to ocular diseases, the efficacy of this drug has been widely studied in Grave’s orbitopathy [9, 10]. Moreover, a recent review by Ruiz-Medrano et al [11] describes the good response to tocilizumab in other ocular inflammatory diseases such as anterior uveitis associated with juvenile idiopathic arthritis, uveitis in association to Castleman disease, uveitis-related refractory macular edema, Birdshot chorioretinopathy, Behçet disease, and in retinal vasoproliferative tumors. Despite all these diseases showing a positive response to the treatment, there is no evidence of a favorable response in IOI.…”

Section: Discussionmentioning

confidence: 99%

Tocilizumab in a Case of Refractory Idiopathic Orbital Inflammation: 6-Year Follow-Up Outcomes

Artieda¹,

Elias²

2020

Case Rep Ophthalmol

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Idiopathic orbital inflammation (IOI) is a noninfectious inflammatory disease whose etiology remains unknown. Treatment is focused on reducing inflammation, which becomes challenging in nonresponding cases. We report the case of a 59-year-old woman with refractory IOI that showed a positive response to tocilizumab therapy. The patient was diagnosed with a unilateral sclerosing IOI for 9 years and showed a negative control with previous oral steroids, peribulbar steroid injections, radiotherapy, immunosuppressors, and intravenous rituximab. After the initiation of 8 mg/kg intravenous tocilizumab, a complete reduction of the pain and the orbital inflammation signs was observed and her condition remained stable for the following 6 years under a monthly dose of 4 mg/kg. In recalcitrant IOI cases, tocilizumab could be considered a possible treatment to reduce inflammatory signs and symptoms with positive long-term outcomes as in our case.

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“…Also, Ruiz-Medrano et al compiled data on the use of tocilizumab in the treatment of ocular conditions between 2011 and 2017. They found that tocilizumab is effective in the treatment of variety of ocular inflammatory conditions including refractory uveitis [173].…”

Section: Tocilizumabmentioning

confidence: 99%

Biological Therapies that Target Inflammatory Cytokines to Treat Uveitis

Reddy¹,

Muhammad²,

Lee³

2019

Advances in the Diagnosis and Management of Uveitis

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Uveitis is a leading cause of blindness that presents a considerable challenge given that our understanding of the mechanisms of disease is still evolving. Both innate and adaptive immunity play a role in disease and mediators of these responses can serve as therapeutic targets. TNF-α and IL-1β inflammatory cytokines are central mediators of immunity and are involved in the dysregulated inflammatory response during uveitis. Because toxicity limits the use of steroids and other steroid-sparing agents, biologics that target a specific cell type or pathway are being explored for the treatment of autoimmune uveitis. This chapter begins with a broad overview of the aberrant immune response resulting in uveitis, and highlights key mediators such as TNF-α, IL-1β, IL-6, and IL-17 and their potential use as therapeutic targets. Most biological agents discussed in this review have not been FDAapproved for uveitis. However, favorable outcomes in early trials and FDA approval of these drugs for the treatment of other autoimmune diseases associated with uveitis support the potential for these biological agents in the management of uveitis. This review aims to provide an updated report on the efficacy of biologics that target TNF-α, IL-1β, IL-6, and IL-17 for the treatment of autoimmune uveitis.

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The role of tocilizumab in the treatment of inflammatory diseases of the eye and orbit: A useful alternative

Cited by 13 publications

References 56 publications

Serious adverse events with tocilizumab: Pharmacovigilance as an aid to prioritize monitoring in COVID‐19

Serious adverse events with tocilizumab: Pharmacovigilance as an aid to prioritize monitoring in COVID‐19

Tocilizumab in a Case of Refractory Idiopathic Orbital Inflammation: 6-Year Follow-Up Outcomes

Biological Therapies that Target Inflammatory Cytokines to Treat Uveitis

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