Tocilizumab for the Treatment of Behcet Uveitis that Failed Interferon Alpha and Anti-Tumor Necrosis Factor-Alpha Therapy

Purpose: To report the results of tocilizumab (TCZ) treatment in patients with Behcet uveitis (BU) who had failed conventional, interferon alpha, and anti-Tumor necrosis factor-alpha therapy. Methods: We reviewed the records of five patients with BU treated with monthly infusions of TCZ 8 mg/kg. Outcome measures were visual acuity, anterior chamber cells, laser flare meter (LFM) readings, vitreous haze, central macular thickness (CMT), and fluorescein angiography (FA) score. Results: The clinical inactivity of BU and 20/50 or better vision were achieved in three female and two male patients treated with TCZ for 5-19 months. The mean LFM reading was reduced from 15.4 +/- 2.7 to 5.0 +/- 0.9 ph/ms; the mean CMT from 324.7 +/- 36.6 mu m to 280.2 +/- 34.1 mu m; and the mean FA score from 20.6 +/- 5.4 to 9.3 +/- 4.5 mu m at the last visit. The only side effect was a slight elevation of the total cholesterol level in one patient. Conclusions: Tocilizumab may be a safe and effective therapeutic option for refractory BU.