The Efficacy and Safety of Intravenous Tocilizumab to Treat Graves’ Ophthalmopathy: A Systematic Review and Single-arm Meta-analysis
Authors' conclusion
This meta-analysis provides robust evidence supporting the efficacy and safety of IV TCZ in patients with GO who are resistant to glucocorticoid therapy. The results highlight TCZ's comparable efficacy to glucocorticoids and suggest that TCZ could significantly expand clinical management options for GO. In the future, more high-quality, large-scale randomized controlled trials are still needed to confirm these findings.
Study context
- Population
- Patients with active, steroid-resistant Graves' ophthalmopathy (GO)
- Participants
- 219 patients12 studies
- Outcome
- Efficacy responses with IV TCZ
Methodological detailsrandomized controlled trials and cohort studies included
- Randomized controlled trials and cohort studies included
Pooled result
As reported in the abstract
Clinical Activity Score (CAS) response, effect size
0.98
95% CI 0.93–1.00
Proptosis response, effect size
0.50
95% CI 0.27–0.73
Diplopia response, effect size
0.48
95% CI 0.24–0.74
Further pooled results
Change from baseline with intravenous (IV) tocilizumab (TCZ)
- Mean CAS reduction, points (95% CI 3.88-5.32), 10 studies
- 4.60
- Mean proptosis reduction, mm (95% CI 1.42-2.65), 7 studies
- 2.04
- Mean decrease in TSH receptor antibodies, IU (95% CI 4.67-10.62), 5 studies
- 10.62
Safety
- Adverse events, effect size
- 0.27 (95% CI 0.22-0.33)
- Severe cases necessitating treatment discontinuation
- 3
- Reactivation rate, effect size
- 0.01 (95% CI 0.00-0.04)
Original publication
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