Sarilumab in the management of Graves orbitopathy with low clinical activity scores

We aim to investigate the efficacy and safety of Sarilumab 150 mg and 200 mg administered subcutaneously in the treatment of cases of patients with Graves orbitopathy (GO) with low clinical activity scores and a reported impaired quality of life. We performed a retrospective, longitudinal study of patients diagnosed with GO and EUGOGO's clinical activity score (CAS) 1 to 3 out of 10 treated with Sarilumab at a single center, Centro Oftalmologico Moreiras. Inclusion between January 2019 and January 2024. Main primary outcomes included reduction in the CAS and Thyroid stimulating immunoglobulin (TSI) blood levels. The GO-QOL questionnaire was used to evaluate the quality-of-life impairment. Sixty-two patients (mean age 44.23 years, 80.6% female) met the inclusion criteria. The mean number of Sarilumab sessions was 3.42. After treatment we observed a significant reduction from an initial mean CAS of 2.22 to a final mean CAS of 0.05. TSI levels were significantly reduced after treatment, from an initial mean TSI of 38.70 U/L to a final mean of 10.53 U/L. The GO-QOL baseline mean total score was 64.72%, which significantly improved to 96.38% after treatment. No major adverse events were registered. Our findings suggest that Sarilumab is an effective and safe option for the treatment of low CAS GO.