Tocilizumab for refractory uveitis associated with juvenile idiopathic arthritis: A report of two cases

Abstract

What is known and the objective: Low-grade evidence supports the use of newer biologics for otherwise refractory juvenile idiopathic arthritis (JIA)-associated uveitis, such as tocilizumab.

Case summary: This report details the cases of two adolescents whose severe JIA-associated uveitis was unresponsive to the first-line therapeutic approach. Tocilizumab therapy led to the remission of uveitis after a mean time of 3 weeks, and methotrexate was safely discontinued 1.5 years later.

What is new and conclusion: To our knowledge, these are the first reports of successful methotrexate withdrawal during tocilizumab treatment of JIA-associated uveitis. The administration of tocilizumab without methotrexate could be considered in patients with JIA-associated uveitis unresponsive to conventional therapy.

Keywords: biologics; child; juvenile idiopathic arthritis; refractory; tocilizumab; uveitis.