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Tocilizumab for Non-Infectious Uveitis: A Systematic Review
Haixing Cao1, Kaiyu Bian1, Cong Ma1
1Department of Ophthalmology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, People's Republic of China.
Journal of Inflammation Research
|September 26, 2025
Summary
Tocilizumab (TCZ) shows promise for treating non-infectious uveitis (NIU) when standard therapies fail. This review found TCZ improved vision and controlled inflammation in most patients with refractory NIU.
Area of Science:
- Ophthalmology
- Immunology
- Rheumatology
Background:
- Non-infectious uveitis (NIU) causes severe ocular inflammation and vision loss.
- Existing treatments like corticosteroids and immunosuppressants are often inadequate.
- NIU significantly impacts patients' quality of life due to chronic symptoms and treatment challenges.
Purpose of the Study:
- To systematically review the efficacy and safety of tocilizumab (TCZ) for treating NIU.
- To evaluate TCZ's effectiveness in patients with refractory NIU unresponsive to other treatments.
Main Methods:
- Systematic literature search of PubMed, Web of Science, and Embase up to May 1, 2025.
- Inclusion of case reports and small studies reporting visual acuity and intervention details.
- Methodological quality assessed using Newcastle-Ottawa Scale and risk of bias using JBI tool.
Main Results:
- The review included 96 patients, with Behçet's disease and panuveitis being common.
- Most patients had failed multiple prior immunosuppressants and biologics.
- TCZ improved vision in 62.5%, controlled inflammation in 83.3%, and resolved macular edema in 90.9% of patients.
- Overall, 83.3% of patients showed a favorable response to TCZ.
Conclusions:
- Tocilizumab (TCZ) is an effective alternative for refractory non-infectious uveitis (NIU).
- TCZ demonstrates significant potential in improving visual outcomes and controlling ocular inflammation.
- Further research into TCZ's long-term safety and efficacy in NIU is warranted.
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