Tocilizumab in refractory pretibial myxedema: new therapeutic insights.
- 1Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, CA, Italy.
- 2Ophthalmology Unit, Department of Surgical Sciences, University of Cagliari, 09042 Monserrato, CA, Italy.
Abstract
Pretibial myxedema (PTM) is a rare extrathyroidal manifestation of Graves disease, often associated with Graves orbitopathy (GO). Tocilizumab, an interleukin-6 receptor inhibitor, is effective in refractory GO, but its role in PTM is unclear. We report the case of a 72-year-old woman with longstanding Graves disease who developed glucocorticoid-refractory GO and diffuse glucocorticoid-refractory PTM. Tocilizumab (8 mg/kg intravenously every 4 weeks) was initiated as second-line treatment of moderate to severe active GO. After 6 infusions, the patient experienced a significant improvement in both activity and severity of GO, while PTM showed near-complete resolution of edema and skin induration. No adverse events were recorded. Our findings suggest that interleukin-6 receptor inhibition with tocilizumab may represent a novel therapeutic option for refractory thyroid dermopathy, particularly in the setting of concomitant GO.
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BibTeX
@article{corrias2026tocilizumab,
title = {{Tocilizumab in refractory pretibial myxedema: new therapeutic insights.}},
author = {Silvia Corrias and Aurora Arba and Filippo Lixi and Giuseppe Giannaccare and Francesco Boi and Giulia Lanzolla},
journal = {JCEM case reports},
year = {2026},
month = oct,
doi = {10.1210/jcemcr/luag249},
url = {https://europepmc.org/article/MED/42923586},
note = {CC BY},
}
RIS
TY - JOUR
TI - Tocilizumab in refractory pretibial myxedema: new therapeutic insights.
AU - Silvia Corrias
AU - Aurora Arba
AU - Filippo Lixi
AU - Giuseppe Giannaccare
AU - Francesco Boi
AU - Giulia Lanzolla
PY - 2026
DA - 2026/10/22
JO - JCEM case reports
DO - 10.1210/jcemcr/luag249
UR - https://europepmc.org/article/MED/42923586
AB - Pretibial myxedema (PTM) is a rare extrathyroidal manifestation of Graves disease, often associated with Graves orbitopathy (GO). Tocilizumab, an interleukin-6 receptor inhibitor, is effective in refractory GO, but its role in PTM is unclear. We report the case of a 72-year-old woman with longstanding Graves disease who developed glucocorticoid-refractory GO and diffuse glucocorticoid-refractory PTM. Tocilizumab (8 mg/kg intravenously every 4 weeks) was initiated as second-line treatment of moderate to severe active GO. After 6 infusions, the patient experienced a significant improvement in both activity and severity of GO, while PTM showed near-complete resolution of edema and skin induration. No adverse events were recorded. Our findings suggest that interleukin-6 receptor inhibition with tocilizumab may represent a novel therapeutic option for refractory thyroid dermopathy, particularly in the setting of concomitant GO.
SN - 2755-1520
ER -