{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T18:08:35Z","timestamp":1783102115121,"version":"3.54.6"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Hintergrund Aufgrund des variablen Verlaufs der endokrinen Orbitopathie (EO) sollte die Therapie individuell an den Schweregrad, die Risikofaktoren und den Krankheitsverlauf der Patienten angepasst werden. Anhand der Ergebnisse einer retrospektiven Analyse am Orbitazentrum der Universit\u00e4tsaugenklinik Essen zeigt diese Studie die Wirksamkeit des IL-6-Rezeptorblockers Tocilizumab als Second-Line-Therapie bei therapierefrakt\u00e4rer EO.<\/jats:p>\n                  <jats:p>Patienten\/Methoden Nach Kl\u00e4rung der Kosten\u00fcbernahme wurden 20 Patienten \u00fcber einen Zeitraum von 4,8\u2009\u00b1\u20092,7 Monaten mit Tocilizumab behandelt. Erfasst wurden folgende Parameter: Geschlecht, Alter, begleitende Schilddr\u00fcsenerkrankung, Aktivit\u00e4t und Schweregrad der EO, Vortherapien, Visus, Augendruck, Lidstellung, Exophthalmus, monokul\u00e4re Exkursionen und Schielstellung\/Diplopie, Spiegel der TSH-Rezeptor-Antik\u00f6rper (TRAK) und Nebenwirkungen.<\/jats:p>\n                  <jats:p>Ergebnisse Das Geschlechtsverh\u00e4ltnis betrug 3\u200a:\u200a1 (F\u200a:\u200aM). Das durchschnittliche Alter betrug 58,2\u2009\u00b1\u20098,5 Jahre. Die \u00fcberwiegende Mehrheit (90%, n\u2009=\u200918) litt an Morbus Basedow; je ein Patient wies eine prim\u00e4re Hypothyreose bzw. einen euthyreoten Stoffwechsel auf. Alle Patienten waren zuvor ohne Erfolg unterschiedlich behandelt worden (kumulative Steroiddosis im Median 4,6\u2009g [1,5\u200a\u2013\u200a7,5\u2009g], 55% Mycophenolat, 65% Orbitaspitzenbestrahlung, 20% balancierte Orbitadekompression). Von 17 Patienten mit nachweisbaren TRAK zum Beginn der Tocilizumab-Therapie betrug der mittlere R\u00fcckgang der TRAK-Spiegel 48,4%. Eine Reduktion von mindestens 30% wurde bei 70,6% der Patienten (n\u2009=\u200917) erreicht. Eine Reduktion des Clinical Activity Score (CAS) um \u2265\u20092 Punkte wurde bei 70% beobachtet. Der mittlere Inflammationsscore (maximal 20 Punkte pro Patient) sank von 8,8\u2009\u00b1\u20093,9 Punkte auf 3,4\u2009\u00b1\u20092,4 Punkte. Die Wirkung auf den Exophthalmus war moderat: im Durchschnitt zeigte sich eine Reduktion um\n          0,9\u2009mm\u2009\u00b1\u20091,8\u2009mm (Spanne \u2212\u20096\u2009mm\u200a\u2013\u200a+\u20093\u2009mm). Eine Reduktion um \u2265\u20092\u2009mm wurde bei 25% der Patienten erreicht. Eine Zunahme des Exophthalmus wurde in 12,5% (0,5\u200a\u2013\u200a3\u2009mm) gesehen.<\/jats:p>\n                  <jats:p>Eine Verbesserung der Augenmotilit\u00e4t wurde bei 22,5% der Patienten dokumentiert, jedoch auch in 10% Verschlechterung.<\/jats:p>\n                  <jats:p>Diskussion Diese Kohorte umfasst durchweg therapierefrakt\u00e4re Patienten mit zum Teil langer Krankheitsdauer. Die signifikante Reduktion der Entz\u00fcndung und insbesondere der TRAK-Spiegel als Biomarker der Krankheitsaktivit\u00e4t belegen die Wirksamkeit von Tocilizumab bei dieser speziellen Kohorte. Damit ist Tocilizumab ein wichtiger Kandidat f\u00fcr eine Therapie bei Patienten mit hohen Antik\u00f6rperwerten und vorwiegend inflammatorischen Erkrankungszeichen. In weiteren Studien muss \u00fcberpr\u00fcft werden, ob es das Rezidivrisiko nach erfolgreicher Behandlung mit einem IGF-1-Rezeptorblocker senkt.<\/jats:p>","DOI":"10.1055\/a-2737-3576","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T23:52:47Z","timestamp":1762213967000},"page":"1200-1210","source":"Crossref","is-referenced-by-count":3,"title":["Assessing the Role of Tocilizumab in the Treatment of Thyroid Eye Disease: A Retrospective Single Centre Analysis"],"prefix":"10.1055","volume":"242","author":[{"given":"Inga","family":"Neumann","sequence":"additional","affiliation":[{"name":"Augenklinik, Universit\u00e4t Duisburg-Essen, Universit\u00e4tsmedizin Essen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Augenklinik, Universit\u00e4t Duisburg-Essen, Universit\u00e4tsmedizin Essen, 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Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Eckstein","sequence":"additional","affiliation":[{"name":"Augenklinik, Universit\u00e4t Duisburg-Essen, Universit\u00e4tsmedizin Essen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1038\/s41572-020-0184-y","article-title":"Graves\u02bc disease","volume":"6","author":"T F Davies","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1111\/cen.14296","article-title":"Prevalence of thyroid eye disease in Graves\u02bc disease: A meta-analysis and systematic review","volume":"93","author":"Y H Chin","year":"2020","journal-title":"Clin Endocrinol 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