title: Tocilizumab in uveitis refractory to other biologic drugs: a study of 3 cases and a literature review.
abstract: OBJECTIVE
  To evaluate the clinical response to Tocilizumab (TCZ) in three patients with non-infectious uveitis refractory to anti-TNF-α drugs.
  
  
  METHODS
  Assessment of TCZ-treated patients with immune-mediated uveitis from two Spanish medical referral centers. Uveitis had been refractory to previous standard synthetic immunosuppressive drugs and at least one TNF-α inhibitor. A literature review of patients with immune-mediated uveitis treated with TCZ therapy was also conducted.
  
  
  RESULTS
  3 women (5 eyes) with uveitis refractory to conventional immunosuppressive therapy and at least one anti-TNF-α drug were treated with TCZ. The mean age of the patients was 48.6±16.1 (range 37-67) years. In two cases uveitis was bilateral and in the other unilateral. The underlying diseases were rheumatoid arthritis in one case and Behçet's disease in the other two cases. After a mean follow-up of 7.3±5.7 (range 1-12) months using TCZ therapy, all patients experienced ocular improvement. Also, in 3 eyes inactive intraocular inflammation was achieved. None of the patients had side effects during the period of treatment with this drug. A literature review disclosed that our observations are in keeping with other reports that showed good response to TCZ in 11 of 12 patients with immune-mediated uveitis refractory to other biologic agents.
  
  
  CONCLUSIONS
  TCZ appears to be an effective and safe therapy for the management of patients with uveitis refractory to other biologic drugs.
authors.affiliation: Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain. fiorelfa@hotmail.com.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Calvo-Río
authors.forename: David
authors.initials: D
authors.lastname: de la Hera
authors.forename: Emma
authors.initials: E
authors.lastname: Beltrán-Catalán
authors.forename: Ricardo
authors.initials: R
authors.lastname: Blanco
authors.forename: Marisa
authors.initials: M
authors.lastname: Hernandez
authors.forename: Lucía
authors.initials: L
authors.lastname: Martínez-Costa
authors.forename: Javier
authors.initials: J
authors.lastname: Loricera
authors.forename: Joaquín
authors.initials: J
authors.lastname: Cañal
authors.forename: Juan
authors.initials: J
authors.lastname: Ventosa
authors.forename: Francisco
authors.initials: F
authors.lastname: Ortiz-Sanjuán
authors.forename: Trinitario
authors.initials: T
authors.lastname: Pina
authors.forename: M Carmen
authors.initials: MC
authors.lastname: González-Vela
authors.forename: Paz
authors.initials: P
authors.lastname: Rodríguez-Cundín
authors.forename: Miguel A
authors.initials: MA
authors.lastname: González-Gay
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016896:Treatment Outcome; D014605:Uveitis / Q000188:drug therapy* / Q000473:pathology
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; C502936:tocilizumab