Effectiveness of Tocilizumab in Cranial and Extracranial Phenotypes of Giant Cell Arteritis: Multicenter Study of 471 Cases

Lara Sánchez-Bilbao¹, Javier Loricera¹, Santos Castañeda², Clara Moriano³, Javier Narvaez⁴, Vicente Aldasoro⁵, Olga Maíz⁶, Rafael Melero⁷, Juan Ignacio Villa⁸, Paloma Vela⁹, Susana Romero-Yuste¹⁰, José Luis Callejas¹¹, Eugenio De Miguel¹², Eva Galindez-Agirregoikoa¹³, Francisca Sivera¹⁴, Jesús Carlos Fernández-López¹⁵, Carles Galisteo¹⁶, Iván Ferraz-Amaro¹⁷, Juan Carlos Nieto¹⁸, Juan Ramón de Dios¹⁹, Julio Sánchez²⁰, Esther Fernández²¹, Isabel de la Morena²², Patricia Moya²³, Roser Solans-Laqué²⁴, Jose Luis Andreu²⁵, Marcelino Revenga²⁶, Eztizen Labrador²⁷, Andrea García-Valle²⁸, Adela Gallego²⁹, Carlota Iñíguez³⁰, Cristina Hidalgo³¹, Noemí Garrido-Puñal³², Ruth López-González³³, José Andrés Román-Ivorra³⁴, Sara Manrique Arija³⁵, Paz Collado³⁶, Enrique Raya¹¹, Francisco Navarro³⁷, Antoni Juan Mas³⁸, Carmen Ordas³⁹, Maria Dolors Boquet⁴⁰, Noelia Álvarez-Rivas⁴¹, Maria Luisa Velloso-Feijoo⁴², Cristina Campos-Fernández⁴³, Íñigo Rúa-Figueroa⁴⁴, Arantxa Conesa⁴⁵, Eva Salgado⁴⁶, Miguel Ángel gonzalez-Gay⁴⁷ and Ricardo Blanco⁴⁸, ¹Hospital Universitario Marqués de Valdecilla, Santander, Spain, ²Hospital Universitario de la Princesa, Madrid, Spain, ³Hospital Universitario de León, León, Spain, ⁴Division of Rheumatology, Hospital Universitario de Bellvitge, Barcelona, Spain, ⁵Complejo Hospitalario de Navarra, Pamplona, Spain, ⁶Hospital Universitario de Donostia, San Sebastián, Spain, ⁷Complexo Hospitalario Universitario de Vigo, Vigo, Galicia, Spain, ⁸Hospital Sierrallana, Torrelavega, Spain, ⁹Hospital General Universitario de Alicante, Alicante, Spain, ¹⁰Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain, ¹¹Hospital San Cecilio, Granada, Spain, ¹²Hospital Universitario La Paz, Madrid, Spain, ¹³Hospital Universitario de Basurto, Bilbao, Spain, ¹⁴Hospital Universitario de Elda, Alicante, Spain, ¹⁵Hospital Universitario Juan Canalejo, A Coruña, Spain, ¹⁶Hospital Universitari Parc Tauli, Saadell, Spain, ¹⁷Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain, ¹⁸Hospital General Universitario Gregorio Marañón, Madrid, Spain, ¹⁹Hospital Universitario de Araba, Mondragón, Spain, ²⁰Hospital Universitario 12 de Octubre, Madrid, Spain, ²¹Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain, ²²Hospital Clínico Universitario de Valencia, Valencia, Spain, ²³Hospital Sant Pau, Barcelona, Spain, ²⁴Hospital Vall d'Hebron, Barcelona, Spain, ²⁵Hospital Universitario Puerta de Hierro, Madrid, Spain, ²⁶Hospital Universitario Ramón y Cajal, Madrid, Spain, ²⁷Hospital San Pedro, Logroño, La Rioja, Spain, ²⁸Complejo Asistencial Universitario de Palencia, Palencia. Spain, Palencia, Spain, ²⁹Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain, ³⁰Hospital Universitario Lucus Augusti, Lugo, Galicia, Spain, ³¹Hospital Universitario Salamanca, Salamanca, Spain, ³²Hospital Universitario Virgen del Rocío, Sevilla, Spain, ³³Complejo Hospitalario de Zamora, Zamora, Spain, ³⁴Hospital Universitario y Politécnico La Fe, Valencia, Spain, ³⁵Hospital Regional de Málaga, Málaga. Spain., Malaga, Spain, ³⁶Hospital Universitario Severo Ochoa, Madrid, Spain, ³⁷Hospital General Universitario de Elche, Elche, Spain, ³⁸Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain, ³⁹Hospital de Cabueñes, Gijón, Spain, ⁴⁰Hospital Arnau de Vilanova, Lleida. Spain., Lleida, Spain, ⁴¹Hospital San Agustín, Aviles, Spain, ⁴²Hospital Universitario de Valme, Sevilla, Spain, ⁴³Consorci Hospital General Universitari de Valencia, Valencia, Spain, ⁴⁴Hospital Universitario Doctor Negrín, Gran Canaria, Spain, ⁴⁵Hospital Universitario de Castellón, Castellón, Spain, ⁴⁶Complejo Hospitalario Universitario de Ourense, Ourense, Spain, ⁴⁷Research group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, Division of Rheumatology, Hospital Universitario Marqués de Valdecilla; School of Medicine, Universidad de Cantabria, Santander, Spain. Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa, ⁴⁸Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain

Meeting: ACR Convergence 2021

Keywords: Biologicals, giant cell arteritis, Polymyalgia Rheumatica (PMR), Vasculitis

Session Information

Date: Monday, November 8, 2021

Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster I: Giant Cell Arteritis & Polymyalgia Rheumatica (1391–1419)

Session Type: Poster Session C

Session Time: 8:30AM-10:30AM

Background/Purpose: Giant cell arteritis (GCA) may be divided into cranial, and extracranial GCA phenotypes. Tocilizumab (TCZ) has shown efficacy and safety in GCA.
Our aim was to compare the efficacy of TCZ in cranial and extracranial phenotypes of GCA.

Methods: Multicenter observational study of 471 patients with GCA treated with TCZ. Patients were divided into 3 groups: a) exclusively cranial involvement (cGCA), b) exclusively extracranial involvement (ecGCA) and c) mixed involvement (mixGCA). GCA was diagnosed by: a) ACR criteria and/or b) temporal artery biopsy and/or c) imaging tests. Remission and sustained remission were defined according to EULAR definitions. In ecGCA and mixGCA we also assessed improvement (complete or partial) by imaging techniques.

Results: We studied 471 patients (342 women/129 men; mean age: 74±9 years). TABLE shows the main characteristics of the 3 groups. Remission at 6 months was observed in a higher number of patients with cGCA, as well as the sustained remission at 12, 18 and 24 months (FIGURE). Partial/complete improvement by imaging techniques at 6, 12, 18 and 24 months was 67%/17%, 58%/19%, 63%/16% and 56%/33%, respectively in ecGCA, and 81%/12%, 57%/29%, 85%/11% and 73%/13% in mixGCA.

Conclusion: TCZ seems to be more effective in the cGCA phenotype. Improvement by imaging techniques was partial and rarely complete in ecGCA and mixGCA.

Disclosures: L. Sánchez-Bilbao, None; J. Loricera, None; S. Castañeda, None; C. Moriano, None; J. Narvaez, None; V. Aldasoro, None; O. Maíz, None; R. Melero, None; J. Villa, None; P. Vela, None; S. Romero-Yuste, Abbvie, 2, 6, MSD, 5, Pfizer, 5, Novartis, 5, Biogen, 2, 6, Amgen, 6, Grünenthal, 6, Kern Pharma, 6, Lilly, 2, 6, Roche, 6, Sandoz, 6, Sanofi, 6, UCB, 6, Janssen, 2, 6, Fresenius Kabi, 2, Gebro, 2, BMS, 2, 5, Galapagos, 2; J. Callejas, None; E. De Miguel, Roche, 6, 12, Paid instructor, Abbvie, 2, 5, 6, Novartis, 2, 5, 6, 12, Paid instructor, Pfizer, 2, 5, 6, MSD, 6, BMS, 6, UCB, 6, Grunental, 6, Janssen, 6, 12, Paid instructor, Sanofi, 6, Galapagos, 2; E. Galindez-Agirregoikoa, None; F. Sivera, None; J. Fernández-López, None; C. Galisteo, None; I. Ferraz-Amaro, None; J. Nieto, None; J. de Dios, None; J. Sánchez, None; E. Fernández, None; I. de la Morena, None; P. Moya, None; R. Solans-Laqué, None; J. Andreu, None; M. Revenga, None; E. Labrador, None; A. García-Valle, None; A. Gallego, None; C. Iñíguez, None; C. Hidalgo, None; N. Garrido-Puñal, None; R. López-González, None; J. Román-Ivorra, None; S. Manrique Arija, None; P. Collado, None; E. Raya, None; F. Navarro, None; A. Mas, None; C. Ordas, None; M. Boquet, None; N. Álvarez-Rivas, None; M. Velloso-Feijoo, None; C. Campos-Fernández, None; . Rúa-Figueroa, None; A. Conesa, None; E. Salgado, None; M. gonzalez-Gay, None; R. Blanco, Brystol Myers Squibb, 6.

To cite this abstract in AMA style:

Sánchez-Bilbao L, Loricera J, Castañeda S, Moriano C, Narvaez J, Aldasoro V, Maíz O, Melero R, Villa J, Vela P, Romero-Yuste S, Callejas J, De Miguel E, Galindez-Agirregoikoa E, Sivera F, Fernández-López J, Galisteo C, Ferraz-Amaro I, Nieto J, de Dios J, Sánchez J, Fernández E, de la Morena I, Moya P, Solans-Laqué R, Andreu J, Revenga M, Labrador E, García-Valle A, Gallego A, Iñíguez C, Hidalgo C, Garrido-Puñal N, López-González R, Román-Ivorra J, Manrique Arija S, Collado P, Raya E, Navarro F, Mas A, Ordas C, Boquet M, Álvarez-Rivas N, Velloso-Feijoo M, Campos-Fernández C, Rúa-Figueroa , Conesa A, Salgado E, gonzalez-Gay M, Blanco R. Effectiveness of Tocilizumab in Cranial and Extracranial Phenotypes of Giant Cell Arteritis: Multicenter Study of 471 Cases [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/effectiveness-of-tocilizumab-in-cranial-and-extracranial-phenotypes-of-giant-cell-arteritis-multicenter-study-of-471-cases/. Accessed .

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