Tocilizumab in Giant Cell Arteritis: A Multicentre Open-Label Study in France

Alexis Regent¹, Serge Redeker², Alban Deroux³, Pierre Kieffer⁴, Kim Heang Ly⁵, Maxime Dougados⁶, Claire Larroche⁷, Loïc Guillevin¹, Laurence Bouillet⁸, Olivier Espitia⁹, Nathalie Costedoat-Chalumeau¹⁰, Martin Soubrier¹¹, Benoit Brihaye¹², François Lifermann¹³, Guillaume Lefèvre¹⁴, Xavier Puéchal¹, Luc Mouthon¹, Eric Toussirot¹⁵ and GFEV and CRI, ¹Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Paris, France, ²43 rue de l'isle, Ch Abbeville, Abbeville, France, ³Internal Medicine, CHU Grenoble, Grenoble, France, ⁴Hopital Emile Muller, Mulhouse Cedex 1, France, ⁵CHU de Limoges, Service de médecine interne, Limoges, France, ⁶Medicine Faculty, Paris-Descartes University, Paris, UPRES-EA 4058, Cochin Hospital, Rheumatology B, Paris, France, ⁷Internal Medicine, Paris, France, ⁸CHU, Grenoble, France, ⁹Internal Medicine, Nantes University Hospital, Nantes, France, ¹⁰Internal Medicine Department, Cochin Hospital, “René-Descartes Paris V” University, Paris, France, ¹¹Rheumatology department CHU Clermont-Ferrand, Clermont-Ferrand, France, ¹²Service de médecine interne et médecine polyvalente, Saint Quentin, France, ¹³CH Dax, Dax, France, ¹⁴Service de médecine interne, Centre National de Référence de la Sclérodermie Systémique, Hôpital Claude Huriez, CHRU Lille, Lille, France, ¹⁵Service de Rhumatologie, CHU J Minjoz, Besancon, France

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Biologic drugs, giant cell arteritis, large vessel vasculitis and tocilizumab

Session Information

Date: Monday, November 9, 2015

Title: Vasculitis Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:

To report the French experience on the efficacy and safety of tocilizumab (TCZ) in patients with giant cell arteritis (GCA) and outcome after treatment withdrawal.

Methods:

A retrospective multicenter study included patients treated with TCZ for their GCA. Treatment efficacy was evaluated at a clinical and biological level. Side effects and outcome after treatment withdrawal were also recorded.

Results:

Thirty-four patients (27 women and 7 males) aged 70.5±8.2 (mean±SD) were included. Diagnosis of GCA was based on the ACR criteria (30 patients) and/or on imaging abnormalities suggestive of GCA (8 patients). Treatment included glucocorticoids in all patients and another immunosuppressant before TCZ introduction in 20/34 patients (59%). TCZ (8 mg/kg monthly) was prescribed after a mean disease duration of 18 months (0-107) and patients were treated for a mean of 6.4±4.5 months. It was effective in all but 6 patients who still had mild symptoms while CRP was reduced from 40.4±45.6 mg/L to 1.5±1.8 mg/L (p<0.0001) and glucocorticoids were tapered from 26.3±13.8 to 10.3±8.3 (p<0,0001). One patient died from septic shock and TCZ was stopped in 3 patients for severe adverse events (tuberculous pericarditis, liver cytolysis and neutropenia). Among the 23 patients who stopped treatment (planned medical decision in 2O cases, side effects in 3 cases) eight patients experienced relapses occurring after a mean of 3.5±1.3 months and TCZ was started again in 5 of them.

Conclusion:

Under TCZ therapy, patients with GCA have a rapid and sustained improvement. However, side effects were noticeable and should be kept in mind in these patients. Questions remain regarding the suspensive nature of this treatment and this should be specifically addressed in future studies.

Disclosure: A. Regent, None; S. Redeker, None; A. Deroux, None; P. Kieffer, None; K. H. Ly, None; M. Dougados, None; C. Larroche, None; L. Guillevin, None; L. Bouillet, None; O. Espitia, None; N. Costedoat-Chalumeau, None; M. Soubrier, None; B. Brihaye, None; F. Lifermann, None; G. Lefèvre, None; X. Puéchal, None; L. Mouthon, None; E. Toussirot, None.

To cite this abstract in AMA style:

Regent A, Redeker S, Deroux A, Kieffer P, Ly KH, Dougados M, Larroche C, Guillevin L, Bouillet L, Espitia O, Costedoat-Chalumeau N, Soubrier M, Brihaye B, Lifermann F, Lefèvre G, Puéchal X, Mouthon L, Toussirot E. Tocilizumab in Giant Cell Arteritis: A Multicentre Open-Label Study in France [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/tocilizumab-in-giant-cell-arteritis-a-multicentre-open-label-study-in-france/. Accessed .

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