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The Effects of Tocilizumab in Patients with Active Thyroid Eye Disease Refractory to Corticosteroids

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Summary:Introduction: Thyroid eye disease (TED) is an autoimmune condition related to the production of pro-inflammatory cytokines, such as interleukin-6, that causes enlargement of extraocular muscles and retrobulbar fat, leading to restriction of the eye movements, exophthalmos, and diplopia. The assessment of TED relies on the clinical activity score (CAS). Tocilizumab is an alternative treatment to TED. Aim: Assess the efficacy of TCZ as well as the occurrence of side effects in reducing the activity of TED in patients refractory to corticotherapy (GC) regimen. Methods: Seven patients presented active TED (CAS ≥ 4). We evaluated them before receiving GC treatment, before starting TCZ treatment and after finishing TCZ treatment (post-TCZ) for CAS and thyroid function (Thyroid Stimulating Hormone (TSH), Free Thyroxine (FT4) and TSH Receptor Antibodies (TRAbs)). Results: 3 males and 4 females with a median age of 52 [46-55] years were enrolled in the study. All of them presented a non-active TED post-TCZ. Median TRAbs before treatment with TCZ was 23.30 [1.90-40.00] and after treatment was 1.80 [1.50-4.40]. TRAbs decreased after TCZ treatment (p < 0.043). No other differences were found. Discussion: TCZ is an effective alternative to treat safely TED as it has proved to be effective and safe in reducing symptoms.
Subject:Medicina clínica Clinical medicine
Country:Portugal
Document type:master thesis
Access type:Restricted
Associated institution:Repositório Aberto da Universidade do Porto
Language:English
Origin:Repositório Aberto da Universidade do Porto
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conditionsOfAccess_str restricted access
country_str PT
description Introduction: Thyroid eye disease (TED) is an autoimmune condition related to the production of pro-inflammatory cytokines, such as interleukin-6, that causes enlargement of extraocular muscles and retrobulbar fat, leading to restriction of the eye movements, exophthalmos, and diplopia. The assessment of TED relies on the clinical activity score (CAS). Tocilizumab is an alternative treatment to TED. Aim: Assess the efficacy of TCZ as well as the occurrence of side effects in reducing the activity of TED in patients refractory to corticotherapy (GC) regimen. Methods: Seven patients presented active TED (CAS ≥ 4). We evaluated them before receiving GC treatment, before starting TCZ treatment and after finishing TCZ treatment (post-TCZ) for CAS and thyroid function (Thyroid Stimulating Hormone (TSH), Free Thyroxine (FT4) and TSH Receptor Antibodies (TRAbs)). Results: 3 males and 4 females with a median age of 52 [46-55] years were enrolled in the study. All of them presented a non-active TED post-TCZ. Median TRAbs before treatment with TCZ was 23.30 [1.90-40.00] and after treatment was 1.80 [1.50-4.40]. TRAbs decreased after TCZ treatment (p < 0.043). No other differences were found. Discussion: TCZ is an effective alternative to treat safely TED as it has proved to be effective and safe in reducing symptoms.
documentTypeURL_str http://purl.org/coar/resource_type/c_bdcc
documentType_str master thesis
id ffd7548e-73be-4d3f-ab6b-5f15cd6cd8bb
identifierHandle_str https://hdl.handle.net/10216/141921
language eng
relatedInstitutions_str_mv Repositório Aberto da Universidade do Porto
resourceName_str Repositório Aberto da Universidade do Porto
spellingShingle The Effects of Tocilizumab in Patients with Active Thyroid Eye Disease Refractory to Corticosteroids
Medicina clínica
Clinical medicine
title The Effects of Tocilizumab in Patients with Active Thyroid Eye Disease Refractory to Corticosteroids
topic Medicina clínica
Clinical medicine