Tocilizumab shows promise in treating Graves’ orbitopathy

Tocilizumab, an IL-6 inhibitor targeting IL-6R, could be a safe and cost-effective therapeutic option for patients with active, corticosteroid-resistant, moderate to severe Graves’ orbitopathy, according to a study.

The observational study included 12 patients with moderate to severe GO who had not responded to first-line corticosteroid treatments. These patients received TCZ through intravenous infusions at a dose of 8mg/kg every 28 days for four months. They were then followed up for an additional 6 weeks.

All patients achieved the primary outcome of Clinical Activity Score (CAS) improvement 6 weeks after the treatment course and all patients had inactive disease 6 weeks after the cessation of TCZ treatment. The use of TCZ led to a significant reduction in median CAS by 3 units, TSI levels decreased by 11.02 IU/L, and Hertel scores (measure of eye protrusion) on both the right and left eyes were reduced by 2.3mm and 1.6mm, respectively.

Although diplopia persisted in 25% of patients after TCZ treatment, this result was not statistically significant. Radiological improvements were observed in 75% of patients, while 16.7% showed no response and 8.3% experienced a deterioration in their condition.

Reference
Boutzios G, Chatzi S, Goules AV, et al. Tocilizumab improves clinical outcome in patients with active corticosteroid-resistant moderate-to-severe Graves’ orbitopathy: an observational study. Front Endocrinol (Lausanne). 2023;14:1186105. doi: 10.3389/fendo.2023.1186105. PMID: 37424868; PMCID: PMC10327634.