ECE2024 Eposter Presentations Thyroid (198 abstracts)
Experience of using tocilizumab for the treatment of glucocorticoid-resistant graves orbitopathy
Tatsiana Mokhort 1 , Volha Shyshko 2 , Kseniya Palavinkina 2 , Alena Mokhort 1 & Natalya Likhorad 3
1Belarusian State Medical University, Endocrinology, Minsk, Belarus; 2Minsk City Clinical Endocrinological Center, Minsk, Belarus; 31th City Clinical Hospital, Endocrinology, Minsk, Belarus
Objective: to evaluate the efficacy of tocilizumab (TZM) in the treatment of glucocorticoid-resistant Grave’s orbitopathy (GO).
Materials and Methods: 3 patients with GO on the background of compensated Graves’ disease were observed. Treatment of GO was initiated with methylprednisolone (total doses of 8, 000-13, 1 mg) without significant clinical effect with a CAS of 4 points. After that TZM was administered three times intravenously once a month at a dose of 8 mg / kg.
Results: The table shows the results of the initial CAS values (1) and the results of the examination 1 month after the end of therapy (2). We registered decrease of GO severity: reduction of proptosis, ophthalmotonus depletion and involution of thickness of oculomotor muscles. All patients noted a significant improvement in their quality of life, but 2 patients had minor leukopenia.
| Symptoms | Patient 1 | Patient 2 | Patient 3 | |||
| 1 | 2 | 1 | 2 | 1 | 2 | |
| Spontaneous retrobulbar pain | 1 | - | 1 | - | 1 | - |
| Pain on attempted upward gaze when moving the eyeballs up or to | 1 | - | 1 | - | 1 | - |
| Redness of the eyelids | - | - | 1 | - | - | - |
| Redness of conjunctiva | 1 | - | 1 | - | - | - |
| Swelling of the eyelids | 1 | - | 1 | 1 | 1 | - |
| Inflammation of the caruncle and/or fold | 1 | - | 1 | - | 1 | - |
| Swelling of conjunctiva (chemosis) | 1 | - | 1 | - | - | - |
| Total | 6 | 0 | 7 | 1 | 4 | 0 |
Conclusion: TZM has been shown to be effective in reducing CAS in patients with glucocorticoid-resistant GO, so it can be used to reduce the inflammatory process and severity in patients with GO.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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