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MINI REVIEW article

Front. Endocrinol.

Sec. Thyroid Endocrinology

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1632531

Current concepts of tocilizumab efficacy in active moderate-to-severe corticosteroid-resistant cases of Graves' orbitopathy

Provisionally accepted
Georgios BoutziosGeorgios Boutzios1,2*Anastasia NikolopoulouAnastasia Nikolopoulou1Sofia ChatziSofia Chatzi1Athanasios G TzioufasAthanasios G Tzioufas1,2,3Andreas GoulesAndreas Goules1,2
  • 1Department of Pathophysiology, National and Kapodistrian University of Athens, Athens, Greece
  • 2Research institute for Systemic Autoimmune diseasesee, Athens, Greece
  • 3Biomedical research Foundation Academy of Athens, Athens, Greece

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Graves' orbitopathy (GO) is an autoimmune disease affecting the orbit and the retro-ocular tissues. GO pathogenesis involves multiple complex mechanisms, including the contribution of many inflammatory cytokines, such as interleukin-6 (IL-6). GO severity ranges from mild to severe and sight-threatening cases, with the latter affecting only a small percentage of patients. A considerable number of these patients do not respond to first-line immunosuppressive therapy with weekly intravenous pulses of corticosteroids and therefore, there is an unmet need for a second-line treatment, based on immunosuppressive drugs. In recent years tocilizumab (TCZ), an IL-6 inhibitor, has emerged as an effective and safe alternative option for the treatment of active, moderate-to-severe, refractory to steroids cases of GO. This review focuses on the up-to-date concepts regarding TCZ administration for the management of these patients.

Keywords: Graves' orbitopathy, Thyroid eye disease, IL-6, tocilizumab, efficacy

Received: 21 May 2025; Accepted: 22 Aug 2025.

Copyright: © 2025 Boutzios, Nikolopoulou, Chatzi, Tzioufas and Goules. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Georgios Boutzios, Department of Pathophysiology, National and Kapodistrian University of Athens, Athens, Greece

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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