Changes of blood clinical parameters in patients with Graves' ophthalmopathy before and after treatment with tocilizumab

doi:10.3969/j.issn.1006-7795.2025.04.019

Abstract

Abstract: Objective To systematically analyze the changes in clinical indicators including blood leukocytes and neutrophils, liver and kidney functions, coagulation function, lipids, and levels of thyroid hormones and antibodies in Graves ophthalmopathy (GO) patients who had undergone effective treatment with tocilizumab (TCZ) and to explore their clinical significance. Methods Eighty-five patients with moderately or severely active GO who were effectively treated with TCZ were enrolled. Early morning fasting blood was collected and tested for routine blood, biochemical routine, coagulation function, thyroid hormone and antibodies, and basic information such as gender, age, duration of the disease, history of smoking, comorbidities, and medications were also collected from all patients, so changes in the clinical indicators before and after the treatment could be analyzed and correlation analyses could be carried out. Results Patients with moderately to severely active GO treated with TCZ showed a significant decrease in absolute blood leukocyte and neutrophil values compared with before, and a significant decrease in liver function (alanine transaminase,aspartate aminotransferase,creatinine), cholesterol ( total cholesterol , high-density lipoprotein and low-density lipoprotein) levels were significantly higher than before, and concentrations of coagulation parameters ［prothrombin time , activated partial thromboplastin time,fibrinogen (FIB) and D-dimer］ were significantly decreased. The concentrations of thyroid hormone and thyroid-stimulating hormone levels increased significantly, and the antibody titer of thyrotropin receptor antibody (TRAB) was significantly down-regulated after treatment. TRAB levels were significantly correlated with FIB before treatment. Conclusion Thyroid function and antibody levels improved after TCZ treatment in patients with moderately to severely active GO, but blood leukocytes, liver function and coagulation function changed significantly compared with before. The results of this study confirm the therapeutic effect of TCZ on immune disorders in GO ophthalmopathy, while underscoring the importance of monitoring potential adverse effects in clinical treatment.

Key words: Graves' ophthalmopathy, tocilizumab, leucocyte, coagulation function, thyroid hormones and antibodies, hepatorenal function, fibrinogen

CLC Number:

Xie Rongrong, Xu Xinyu, Song Zhihui, Xin Zhong, Hua Lin, Shi Tingting. Changes of blood clinical parameters in patients with Graves' ophthalmopathy before and after treatment with tocilizumab[J]. Journal of Capital Medical University, 2025, 46(4): 710-717.

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