Tocilizumab for the Management of Corticosteroid-Resistant Mild to Severe Graves' Ophthalmopathy, a Report of Three Cases

Purpose: To discuss the use of tocilizumab in mild to severe Graves' ophthalmopathy as corticosteroid-adjunctive therapy. Methods: Retrospective case reports. Results: Three patients with corticosteroid-resistant or advanced diplopia-associated Graves' ophthalmopathy were subsequently treated with monthly intravenous tocilizumab at a dose of 8 mg/kg. None reported a past or present history of dysthyroidism. The adjunction of interleukin-6-receptor monoclonal antibody treatment was associated with a significant improvement in ocular symptoms, notably diplopia and proptosis, and functional prognosis in all patients, with one relapse approximately two months after the end of the treatment. Conclusion: These clinical reports confirm the relative efficacy and tolerability profile of intravenous tocilizumab in severe or corticosteroid-resistant Graves' ophthalmopathy.