THU0288 LONG-TERM FOLLOW-UP OF ANTI-IL6-RECEPTOR TOCILIZUMAB IN REFRACTORY UVEITIS IN PATIENTS WITH BEHÇET’S DISEASE. MULTICENTER STUDY OF 14 PATIENTS IN CLINICAL PRACTICE

Background Ocular involvement in Behcet’s disease (BD) is a potential severe and disabling complication. Anti-TNF-α agents have shown an improvement of visual outcome in BD-related uveitis refractory to conventional immunosuppressive (IS) drugs. However, these drugs do not achieve control of intraocular inflammation in all patients or are not well tolerated. Tocilizumab (TCZ) has shown efficacy in different refractory ocular inflammatory diseases. Objectives To assess the efficacy of long-term therapy with TCZ in refractory uveitis associated to extraocular manifestations (EOM) due to BD. Methods Multicenter study of patients with BD refractory to standard systemic treatment. Results We followed up 14 patients (9 men/5 women) (26 affected eyes); mean age 40.8±19.5 years. Pattern of ocular involvement: panuveitis (10; 4 with retinal vasculitis), anterior (3) and posterior (1) uveitis; 8 recurrent and 6 chronic; 9 with cystoid macular edema. At TCZ onset the following EOM were present: oral and/or genital ulcers (10), arthritis (6), folliculitis/pseudofolliculitis (6), erythema nodosum (3), livedo reticularis (1), intestinal affection (1) and neurological involvement (3). Before TCZ, they had received corticosteroids (13 intraocular, 12 oral and 12 iv), conventional IS drugs and biologic agents: methotrexate (11), cyclosporine (8), azathioprine (10), colchicine (1), cyclophosphamide (2), mycophenolate mofetil (1), adalimumab (10), infliximab (6), golimumab (3), canakinumab (1), or etanercept (1). TCZ was used in monotherapy (7) or combined with conventional IS drugs (7) at 8 mg/kg/iv/4 w (11) or 162 mg/sc/w (3). After a mean follow-up of 21.7±14.5 months using TCZ, all patients experienced ocular improvement, with complete remission in 10. However, TCZ was only effective in 5 of the patients with EOM. TABLE shows the evolution of ocular parameters. TCZ had to be withdrawn temporally in 1 case, due to an episode of cellulitis with sepsis, and definitely in 4 cases, due to a severe infusion reaction, arthritis impairment, persistence of oral ulcers or a new episode of uveitis (1 each). Prednisone dose was significantly reduced until suspension in all patients. Conclusion TCZ seams a useful and secure therapy in highly refractory BD-related uveitis. References [1] Atienza-Mateo B, Calvo-Rio V, Beltran E, et al. Anti-interleukin 6 receptor tocilizumab in refractory uveitis associated with Behcet’s disease: multicentre retrospective study. Rheumatology (Oxford). 2018 May 1;57(5):856-864. [2] Calvo-Rio V, de la Hera D, Beltran-Catalan E, et al. Tocilizumab in uveitis refractory to other biologic drugs: a study of 3 cases and a literature review. Clin Exp Rheumatol.2014; 32(4 Suppl 84): S54-7. Disclosure of Interests Belen Atienza-Mateo: None declared, Jose Luis Martin-Varillas: None declared, Vanesa Calvo-Rio: None declared, Rosalia Demetrio-Pablo: None declared, Natalia Palmou-Fontana: None declared, J. Loricera: None declared, Emma Beltran: None declared, Marisa Hernandez-Garfella: None declared, Lucia Martinez-Costa: None declared, Elia Valls-Pascual: None declared, Antonio Atanes-Sandoval: None declared, Miguel Cordero-Coma: None declared, Joan Miquel Nolla: None declared, Carmen Carrasco-Cubero: None declared, Julio Sanchez: None declared, Santos Castaneda Consultant for: Amgen, BMS, Pfizer, Lilly, MSD, Roche, Sanofi, UCB, Lara Sanchez Bilbao: None declared, Inigo Gonzalez-Mazon: None declared, Monica Calderon-Goercke: None declared, D. Prieto-Pena: None declared, Miguel A. Gonzalez-Gay: None declared, Ricardo Blanco: None declared