Rapid visual recovery following intravenous tocilizumab in glucocorticoid resistant refractory giant cell arteritis.

Svasti-Salee, Carl Richard and Mollan, Susan P and Morgan, Ann W and Quick, Vanessa (2019) Rapid visual recovery following intravenous tocilizumab in glucocorticoid resistant refractory giant cell arteritis. BMJ case reports, 12 (10). ISSN 1757-790X. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://casereports.bmj.com/content/12/10/e229236....

Abstract

A 72-year-old man presented with a short history of headache, jaw claudication, double vision, amaurosis fugax and distended temporal arteries. A diagnosis of giant cell arteritis (GCA) was confirmed on temporal artery ultrasound and temporal artery biopsy. Despite treatment with high-dose oral glucocorticoid (GC) and multiple pulses of intravenous methylprednisolone, his vision deteriorated to hand movements in one eye. 8 mg/kg intravenous tocilizumab, a humanised, recombinant anti-IL-6 receptor antibody, was administered within 48 hours of vision loss and continued monthly, resulting in marked visual improvement within days, as well as sustained remission of GCA. This case suggests a possible role for tocilizumab as a rescue therapy to prevent or recover visual loss in patients with GCA resistant to GC treatment, termed refractory GCA. Further research is required to elucidate the role of intravenous administration of tocilizumab in this setting.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WW Eyes. Ophthalmology
Divisions: Ambulatory Care > Ophthalmology
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Depositing User: Mr Philip O'Reilly
Date Deposited: 14 Oct 2019 09:59
Last Modified: 14 Oct 2019 09:59
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2479

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