ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2745

Clinical and Serological Outcomes of Patients with Giant Cell Arteritis Treated with Tocilizumab or Abatacept As Steroid-Sparing Agents

Daniela Rossi1, Irene Cecchi2, Elena Rubini3, Massimo Radin4, Savino Sciascia5 and Dario Roccatello6, 1Department of Medicine and Experimental Oncology, CMID - Center of Research of Immunopathology and Rare Diseases, Turin, Italy, 2Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Valle d’Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, Italy, Turin, Italy, 3Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Valle d’Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin and S. Giovanni Bosco Hospital, Turin, Italy., Turin, Italy, 4Department of Clinical and Biological Sciences, Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Valle d’Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, Italy, Turin, Italy, 5Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Valle d’Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, Italy, Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Valle d’Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, Italy, Torino, Italy, 6Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Valle d’Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin and S. Giovanni Bo, Turin, Italy

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: , , ,

Session Information

Date: Tuesday, October 23, 2018

Title: Vasculitis Poster III: Immunosuppressive Therapy in Giant Cell Arteritis and Polymyalgia Rheumatica

Session Type: ACR Poster Session C

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

Background/Purpose:

At least 2 biological therapies [tocilizumab (TCZ) and abatacept (ABA)] have been proven to be effective in the management of Giant cell arteritis (GCA) in randomized controlled trials. Nevertheless, their use as steroid sparing agents might need further investigation.

Methods:

We included GCA patients who were treated with TCZ, both intravenous (IV) and subcutaneous (SC), and/or ABA SC (8 mg/kg/month, 162 mg/week, and 125 mg/week respectively). Complete response to the treatment was define as a clinical and serological remission after 12 months of therapy; partial response as clinical or serological remission after 12 months.

Results:

This study included 33 GCA patients [mean age 74, females 63%, mean follow-up 44±34 months). Figure 1 resumes the characteristics of the GCA patients included in the study. Twenty-eight patients out of 33 (85%) received one biologic agent. Five patients (15%) needed a therapeutic switch (one patient from TCZ to ABA, and 4 patients from ABA to TCZ). Patients were treated as follow: 9 with TCZ IV, 11 with TCZ SC, and 18 with ABA. Among the TCZ IV group, all patients experienced a response (57% complete response, and 43% partial response). Among the TCZ SC group, 83% experienced a response (67% complete response, and 16% partial response). Among the ABA group, 86% experienced a response (36% complete response and 50% partial response). After 12 months of therapy, 100% of patients in TCZ

groups, both IV and SC, and 64% of ABA group were treated with low doses of oral prednisone (≤ 7.5 mg/day) as maintenance. We noticed a significant reduction of inflammatory parameters [C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)] after 12 months of therapy with TCZ [TCZ IV group: mean baseline CRP (mg/dl) 1.9±2.3, mean CRP after 12 months of therapy 0,3±0.2; mean baseline ESR (mm/h) 58.1±25.6, mean ESR after 12 months 9.5±4.2; TCZ SC group: mean baseline CRP 4.5±3.8, mean CRP after 12 months 0.2±0.2; mean baseline ESR 51.9±27, mean ESR after 12 months 6.5±6]. When compared to standard GC regimen, in patients treated with TCZ, both IV and SC, we estimated a median steroid-sparing effect quantifiable in 30 mg/daily in the first month and an overall steroid-sparing effect of 15 mg/daily when assessed in 12 months.

Conclusion:

This study confirms the efficacy of biological therapies in the management of CGA. Besides, in our experience TCZ allowed a significant reduction of GCs use, especially in the first month of therapy, when compared to standard GCs-based regimens.

Figure 1

Disclosure: D. Rossi, None; I. Cecchi, None; E. Rubini, None; M. Radin, None; S. Sciascia, None; D. Roccatello, None.

To cite this abstract in AMA style:

Rossi D, Cecchi I, Rubini E, Radin M, Sciascia S, Roccatello D. Clinical and Serological Outcomes of Patients with Giant Cell Arteritis Treated with Tocilizumab or Abatacept As Steroid-Sparing Agents [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/clinical-and-serological-outcomes-of-patients-with-giant-cell-arteritis-treated-with-tocilizumab-or-abatacept-as-steroid-sparing-agents/. Accessed .

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