Is Tocilizumab an Effective Option for Treatment of Refractory Uveitis Associated with Juvenile Idiopathic Arthritis?

To the Editor: Anti-interleukin 6 receptor (anti-IL-6R) antibodies have been effective in experimental models of autoimmune arthritis, encephalomyelitis, and also uveitis1,2. Tocilizumab (TCZ; RoActemra®, Hoffmann-La Roche, Basel, Switzerland), a fully humanized anti-IL-6R antibody, has been approved for the treatment of rheumatoid arthritis. Efficacy has also been shown for systemic-onset juvenile idiopathic arthritis (JIA)3 and vasculitis4. To date, however, no reports have appeared concerning its efficacy in JIA-associated uveitis. In about one-third of JIA patients with uveitis, eye inflammation runs a severe course and vision-threatening complications develop, and immunosuppressive treatment is required5. Because some patients do not respond properly to the widely used disease-modifying antirheumatic drugs (DMARD), including tumor necrosis factor-α (TNF-α) inhibitors, there is a significant need … Address correspondence to Dr. A. Heiligenhaus, Department of Ophthalmology and Ophtha Lab, St. Franziskus Hospital, Hohenzollernring 74, 48145 Münster, Germany. E-mail: arnd.heiligenhaus{at}uveitis-zentrum.de