Effectiveness and safety of tocilizumab in 2 cases of severe corticosteroid-refractory thyroid orbitopathy. Hospital San José, Bogotá
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Graves Ophthalmopathy
Graves’ Disease

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Sierra Osorio, A., Manosalva Holguín, S., Coy, A., Benavides, J., & Vargas, J. (2021). Effectiveness and safety of tocilizumab in 2 cases of severe corticosteroid-refractory thyroid orbitopathy. Hospital San José, Bogotá. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 7(4), 280–284. https://doi.org/10.53853/encr.7.4.655


Thyroid orbitopathy is the most frequent extrathyroid manifestation of autoimmune hyperthyroidism; more than 90% of cases are associated with Graves’ disease. It is a complex disorder that can cause orbital deformity, double vision and even permanent visual loss, with an impact on the quality of life. Approximately, 2% of patients who develop Graves orbitopathy will develop moderate to severe disease. There is growing awareness of the need for early diagnosis and timely management to reduce irreversible sequelae. Its initial management is glucocorticoids; however, recurrence occurs frequently once they are stopped. In more than 60% of cases, normal orbital anatomy is not restored and rehabilitation surgery is required. In cases of refractoriness, biological therapies are an alternative, which have proven its effectiveness. Among these we have teprotumumab, recently approved by the Food and Drug Administration (FDA), which reduces proptosis; rituximab, that reduces inflammation; and tocilizumab, which potentially benefits both parameters. We describe the effect of tocilizumab in two patients with thyroid orbitopathy at the Hospital San José, in Bogotá.

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