Tocilizumab for giant cell arteritis with corticosteroid-resistant progressive anterior ischemic optic neuropathy.

Détails

ID Serval
serval:BIB_54FC5AA250DD
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Tocilizumab for giant cell arteritis with corticosteroid-resistant progressive anterior ischemic optic neuropathy.
Périodique
Joint, bone, spine
Auteur(s)
Vionnet J., Buss G., Mayer C., Sokolov A.A., Borruat F.X., Spertini F.
ISSN
1778-7254 (Electronic)
ISSN-L
1297-319X
Statut éditorial
Publié
Date de publication
10/2017
Peer-reviewed
Oui
Volume
84
Numéro
5
Pages
615-619
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article ; Review
Publication Status: ppublish
Résumé
Giant cell arteritis is an inflammatory disorder of the medium- and large-size arteries. Permanent visual loss related to arteritic anterior ischemic optic neuropathy is among the most serious complications of this disease and initial treatment usually consists of high dose corticosteroids. There is no consensus in the literature concerning the optimal therapeutic approach in giant cell arteritis patients with corticosteroid-resistant arteritic anterior ischemic optic neuropathy.
A 73-year-old Caucasian female with biopsy-proven giant cell arteritis developed an acute visual loss of the right eye due to arteritic anterior ischemic optic neuropathy. Despite 5 daily methylprednisolone pulses, systemic symptoms persisted and rapid involvement of the controlateral eye was documented. Therefore, tocilizumab (humanised monoclonal antibody binding the human interleukin-6 receptor) was introduced as a potential salvage therapy with a swift consecutive resolution of the systemic symptoms and stabilization of the ophthalmic lesions.
Although a late effect of steroids pulses cannot be formally ruled out in this dramatic situation, tocilizumab likely offered a decisive effect in preventing bilateral blindness and may have contributed to steroid tapering. Tocilizumab may represent a new early effective second-line treatment option in corticosteroid-resistant anterior ischemic optic neuropathy. More data are needed to confirm this observation and to evaluate the safety profile of this treatment.
Mots-clé
Aged, Antibodies, Monoclonal/therapeutic use, Antibodies, Monoclonal, Humanized/therapeutic use, Biopsy, Needle, Drug Therapy, Combination, Female, Fluorescein Angiography/methods, Follow-Up Studies, Giant Cell Arteritis/complications, Giant Cell Arteritis/diagnostic imaging, Giant Cell Arteritis/drug therapy, Humans, Immunohistochemistry, Methylprednisolone/therapeutic use, Optic Neuropathy, Ischemic/drug therapy, Optic Neuropathy, Ischemic/etiology, Optic Neuropathy, Ischemic/pathology, Severity of Illness Index, Treatment Outcome, Anterior ischemic optic neuropathy, Biologics, Corticosteroid-resistant giant cell arteritis, Tocilizumab
Pubmed
Web of science
Création de la notice
11/12/2017 11:07
Dernière modification de la notice
20/08/2019 14:09
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