{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:43:40Z","timestamp":1790628220723,"version":"4.1.0"},"reference-count":42,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Treatment of active, moderate-to-severe thyroid eye disease (TED) remains a challenge. Up to 55% of patients show an incomplete response to intravenous (IV) glucocorticoids (GCs), and relapses are common. Tocilizumab (TCZ), a monoclonal antibody against the interleukin-6 receptor, has been proposed as a second-line therapy for GC-resistant TED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed an open-label, prospective study at two tertiary TED referral centers (Warsaw, Poland; Belgrade, Serbia) from May 2022 to May 2025. Adults with active, moderate-to-severe, GC-resistant TED received TCZ 8 mg\/kg IV every 4 weeks for four cycles and were followed for 24 weeks. Primary endpoints were (1) improvement in the composite ophthalmic score and (2) improvement in disease-specific quality of life (Graves\u2019 ophthalmopathy quality of life questionnaire [GO-QoL]). Secondary endpoints included changes in clinical activity score (CAS), proptosis, eyelid aperture, diplopia, thyrotropin receptor antibody (TRAb) levels, and safety. The trial was registered at ClinicalTrials.gov (NCT06367517).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 44 patients underwent TCZ treatment (Warsaw,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 32; Belgrade,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 12). Both primary endpoints were met by 20\/32 (62.5%) patients at Warsaw and all 12\/12 (100%) patients at Belgrade. CAS reduction by \u22652 points was observed in 24\/32 (75%) and 12\/12 (100%) patients, respectively. A reduction of \u22652 mm in proptosis occurred in 19\/32 (59.4%) and 7\/12 (58.3%). Diplopia improved by \u22651 grade in Gorman score in 7\/32 (21.9%) and 6\/12 (50%). Eyelid aperture decreased by \u22652 mm in 11\/32 (34.4%) and 8\/12 (66.7%). Median TRAb levels decreased from 7.0 to 2.1 IU\/L (Warsaw) and from 4.7 to 2.0 IU\/L (Belgrade). No patients experienced TED deterioration. Adverse events occurred in 18\/44 (40.9%) patients (47 events, only 1 severe).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In this prospective, real-world study conducted in two independent cohorts of patients with GC-resistant, active, moderate-to-severe TED, TCZ was associated with clinically meaningful improvements in composite ophthalmic score response, CAS, proptosis, and quality of life, with a generally acceptable safety profile. These findings support TCZ as an effective and safe second-line therapeutic option for GC-resistant TED.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256261450089","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T09:34:39Z","timestamp":1778578479000},"page":"654-664","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Tocilizumab in Active, Moderate-to-Severe, Glucocorticoid-Resistant Thyroid Eye Disease: An Open-Label Prospective Study in Two Independent Cohorts"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2427-0489","authenticated-orcid":false,"given":"Joanna","family":"Rymuza","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, 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Serbia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota","family":"Bia\u0142as-Niedziela","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Turczy\u0144ska","sequence":"additional","affiliation":[{"name":"Ophthalmology Outpatient Clinic, University Clinical Center, Medical University of Warsaw, Warsaw, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjana","family":"Stojkovi\u0107","sequence":"additional","affiliation":[{"name":"Clinic of Endocrinology, Diabetes and Diseases of Metabolism, University Clinical Center of Serbia, Belgrade, Serbia."},{"name":"Faculty of Medicine, University of Belgrade, Belgrade, Serbia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bojan","family":"Markovi\u0107","sequence":"additional","affiliation":[{"name":"Clinic of 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