Year: 2025
Type: article
Study design: Case Report
Abstract: Thyroid Eye Disease (TED), formerly known as Graves' orbitopathy, is an autoimmune disorder affecting orbital tissues. The Clinical Activity Score (CAS) is used to evaluate TED activity. A score ≥3 indicates active disease, warranting immunomodulatory therapy. Intravenous corticosteroids (IVCS) are the first-line treatment. However, studies show 20-30% of patients with moderately severe active TED have an inadequate response to corticosteroids. For patients with poor response or tolerance to steroids, tocilizumab offers an effective alternative. We present a case of a 49-year-old female with moderately severe, active, corticosteroid-resistant TED. After failure of two corticosteroid regimens (4.5 g and 5 g), biological therapy with tocilizumab (6 cycles of 600 mg every 4 weeks) was initiated. Clinical response was monitored using NOSPECS, CAS, and the Gorman-Bahneman diplopia classification. This case confirms the potential efficacy of tocilizumab in managing corticosteroid-resistant, moderately severe active TED.
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4411274753