Tocilizumab use in pediatric thyroid eye disease: First documented case

Albrashdi, Safiya; Alsharqi, Hessah; Habroosh, Fatima; Eatamadi, Habibullah

doi:10.1016/j.ajoc.2022.101387

Cited by 7 publications

(16 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The dosage applied by his team was 8 mg/kg, while we applied only 4 mg/kg. Although Albrashdi [29] and previous reports in JIA [24,25] suggest a higher dose of tocilizumab, our results show that it may be possible to achieve successful results in children with lower doses. This is a surprising and important finding since side effects may be dose-related.…”

Section: Discussioncontrasting

confidence: 78%

“…Evidence regarding the tocilizumab use in pediatric TED is scarce. To the best of our knowledge, there is only one recent case report of its successful use in a girl [ 29 ]. A few differences need to be stated between both cases.…”

Section: Discussionmentioning

confidence: 99%

“…A few differences need to be stated between both cases. Albrashdi et al [ 29 ] used tocilizumab as an effective first-line therapy in a 9-year-old girl with progressive TED. The dosage applied by his team was 8 mg/kg, while we applied only 4 mg/kg.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous reports describe that TED limits daily activities and reduces self-confidence and social interactions, with higher rates of suicide in affected patients [ 2 ]. Therefore, the 2 cases show that tocilizumab seems to be a safe and effective therapy in children with TED either as a first-line [ 29 ] treatment or as a second line in steroid nonresponders. Nevertheless, more studies, including well-designed clinical trials, are needed to establish the long-term safety and effectiveness of this therapy in larger populations of pediatric patients, as well as to determine the lowest effective dose.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Tocilizumab as a Useful Tool for Thyroid Eye Disease in Pediatric Population: A Case Report

Moleiro

Vilares-Morgado

Alves

et al. 2022

Case Rep Ophthalmol

View full text Add to dashboard Cite

Thyroid eye disease (TED) characterizes by inflammation and remodeling of orbital tissues. Although the majority of pediatric TED is mild, some children present progressive and severe disease. The approach to severe disease in this group of patients, especially when noncortico-responsive, is challenging. The purpose of this work was to describe the effective use of tocilizumab as second-line therapy in steroid-resistant pediatric TED. A 13-year-old female with a history of Graves’ disease presented with right eye proptosis for at least 8 months associated with mild pain on eye movements and ocular surface complaints. The ophthalmologic evaluation revealed Hertel exophthalmometry readings of 22 mm on the right eye (OD) and 19 mm on the left (OS). The remaining ophthalmic examination was unremarkable. Intravenous methylprednisolone pulses of 500 mg were initiated without any improvement after 4 treatments. Following multidisciplinary team discussion, therapy was switched to monthly tocilizumab injections at 4 mg/kg. Significant reduction of proptosis and resolution of pain and ocular surface complaints were noted immediately after the treatment switch. Exophthalmometry readings after the end of treatment that included 4 tocilizumab injections were 20 mm on OD and 19 mm on OS. No side effects were reported during the entire follow-up. Six months after treatment cessation, the patient remains stable, without any signs of orbitopathy relapse and no ophthalmologic complaints. This is the second case report showing the effectiveness of tocilizumab in pediatric TED and the first one showing its efficacy when steroids fail. Our results support the potential safety and efficacy of this immunosuppressor in children with TED.

show abstract

Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Tocilizumab as a Useful Tool for Thyroid Eye Disease in Pediatric Population: A Case Report

Moleiro

Vilares-Morgado

Alves

et al. 2022

Case Rep Ophthalmol

View full text Add to dashboard Cite

show abstract

“…The absolute CAS response (CAS=0 or 1) was achieved in 74% after the fourth dose of tocilizumab, while a relative CAS response (reduction ≥2 points) was reached in 90.9% of patients after the first dose of tocilizumab with significant reduction of proptosis, eyelid retraction, and diplopia noticed after the fourth dose [ 23 ]. Eatamadi et al reported the first case of using tocilizumab in treating progressive pediatric TED [ 24 ]. Other authors have reported cases in which tocilizumab was used for the treatment of TED.…”

Section: Discussionmentioning

confidence: 99%

A 46-Year-Old Woman with a 4-Year History of Graves Disease, with Severe Corticosteroid-Unresponsive Thyroid Eye Disease, Successfully Treated with Tocilizumab

et al. 2023

Self Cite

View full text Add to dashboard Cite

Unusual or unexpected effect of treatment Background:Tocilizumab is a therapeutic biologic antagonist of the interleukin-6 (IL-6) receptor that has been approved to treat some autoimmune and chronic inflammatory diseases. This report is of a patient with a history of Graves disease and severe corticosteroid-unresponsive thyroid eye disease that included edema of the optic nerve and choroid, which was successfully treated with tocilizumab. Case Report:A 46-year-old woman with a 4-year history of Graves disease presented with acutely progressive bilateral severe optic nerve compression, severe bilateral optic nerve edema, bilateral restriction of eye movement, and bilateral choroidal folds. The patient was managed with an initial high dose of systemic steroid without any success. She then underwent bilateral orbital wall decompression without any noticeable amelioration. She subsequently received 4 doses of a tocilizumab (8 mg/kg) infusion. This resulted in a considerable decrease in inflammatory signs and improvement in optic nerve function, thereby improving her quality of life. The patient did not have any adverse reactions to the tocilizumab. Conclusions:The findings from this case support recent case reports and clinical trials indicating that tocilizumab may be effective in corticosteroid-resistant thyroid eye disease associated with autoimmune hyperthyroidism.

show abstract

Tocilizumab use for optic nerve compression in thyroid eye disease: a prospective longitudinal cohort

Habroosh,

Albrashdi,

Alsaadi

et al. 2024

Int Ophthalmol

View full text Add to dashboard Cite

Tocilizumab use in pediatric thyroid eye disease: First documented case

Cited by 7 publications

References 15 publications

Tocilizumab as a Useful Tool for Thyroid Eye Disease in Pediatric Population: A Case Report

Tocilizumab as a Useful Tool for Thyroid Eye Disease in Pediatric Population: A Case Report

A 46-Year-Old Woman with a 4-Year History of Graves Disease, with Severe Corticosteroid-Unresponsive Thyroid Eye Disease, Successfully Treated with Tocilizumab

Tocilizumab use for optic nerve compression in thyroid eye disease: a prospective longitudinal cohort

Contact Info

Product

Resources

About