title: Tocilizumab in severe and refractory non-infectious uveitis.
abstract: OBJECTIVE
  To report the safety and efficacy of tocilizumab in patients with severe and refractory non-infectious uveitis.
  
  
  METHODS
  Eight consecutive unselected patients with severe and refractory non-infectious uveitis [Birdshot chorioretinopathy (n=1), Behçet's disease (n=1) and idiopathic bilateral panuveitis (n=6)] treated with tocilizumab (8mg/kg every 4 weeks intravenously) were included. The primary outcome was the response to treatment, defined by decrease of inflammatory ocular signs.
  
  
  RESULTS
  Four (50%) patients were of female gender and the median (IQR) age was 41 (31-47) years. The median number of previous immunosupressants was of 5.5 (4-6.7). Seven patients had been previously treated with anti-TNF-α [infliximab (n=5) and adalimumab (n=2)]. The immunosupressive drugs used in association with tocilizumab were azathioprine (n=2), mycophenolate mofetil (n=2) and methotrexate (n=2). After a median follow-up of 8 months (6-25), 6/8 (75%) improved under tocilizumab and 2 (25%) were non-responders. The visual acuity improved in five patients. The median dose of prednisolone decreased from 16mg/day (10.6-20.5) to 10 mg/day (10-13.7), at baseline and at the end of follow-up, respectively. Tolerance of tocilizumab was satisfactory and side effects included bronchitis (n=1) and grade 1 leukopenia (n=1) and thrombocytopenia (n=1).
  
  
  CONCLUSIONS
  Tocilizumab seems to be a safe and promising therapy in severe and refractory non-infectious uveitis.
authors.affiliation: Service de Médecine Interne, Hôpital Pitié-Salpêtrière 47-83 boulevard de l'Hôpital 75013 Paris, France. matt.papo@gmail.com.
authors.forename: Matthias
authors.initials: M
authors.lastname: Papo
authors.forename: Philip
authors.initials: P
authors.lastname: Bielefeld
authors.forename: Hélène
authors.initials: H
authors.lastname: Vallet
authors.forename: Pascal
authors.initials: P
authors.lastname: Seve
authors.forename: Bertrand
authors.initials: B
authors.lastname: Wechsler
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
authors.forename: Phuc
authors.initials: P
authors.lastname: Le Hoang
authors.forename: Thomas
authors.initials: T
authors.lastname: Papo
authors.forename: Bahram
authors.initials: B
authors.lastname: Bodaghi
authors.forename: David
authors.initials: D
authors.lastname: Saadoun
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000009:adverse effects; D001528:Behcet Syndrome / Q000150:complications / Q000188:drug therapy*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014605:Uveitis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; C502936:tocilizumab