ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1412

Effectiveness of Tocilizumab in the Visual Involvement of Giant Cell Arteritis: Multicenter Study of 471 Patients of Clinical Practice

Lara Sánchez-Bilbao1, Javier Loricera1, Juan Pablo Valdivieso Achá2, 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, Valvanera Pinillos27, 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 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 Ramón y Cajal, Madrid. Spain., Madrid, Spain, 27Hospital San Pedro, Logroño, 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: , , ,

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: One of the most feared complications of giant cell arteritis (GCA) is visual affection. Tocilizumab (TCZ) has demonstrated efficacy and safety in GCA. However, data on visual affection with TCZ are scarce and sometimes contradictory.

Our objectives were to evaluate the efficacy of TCZ in a)preventing the onset of new visual manifestations, and b)improving visual symptoms when present.

Methods: Multicenter observational study of 471 patients with GCA treated with TCZ of clinical practice. Patients were diagnosed with GCA according to a)ACR criteria, and/or b)temporal artery biopsy, and/or c)imaging techniques.

Patients were divided into 2 groups: a)with visual involvement at some time during the disease, and b)without visual involvement. Visual manifestations were classified as: a)transient visual loss (TVL) (amaurosis fugax), b)permanent visual loss (PVL) (more than 24 hours) (partial or complete; unilateral or bilateral), c)diplopia, and d)blurred vision. According to the duration between the onset of visual symptoms and the onset of TCZ we have considered a)1-10 days, b)11-30 days, and c)more than 30 days.

Results: We studied 471 (342 women/ 129 men; mean age: 74 ± 9 years). Visual manifestations at any time of the disease were observed in 122 (26%) patients. In 81 of them visual manifestations were present at TCZ onset, while the remaining 41 patients had had a complete recovery previously to TCZ. The main GCA features of patients with and without visual involvement are shown in TABLE. Patients with visual involvement were older, with other ischemic complications, and required higher doses of corticosteroids.

After starting TCZ, no patient developed new visual involvement. At TCZ onset, 81 patients had the following visual manifestations: PVL (n= 60; unilateral/bilateral: 48/12), TVL (n= 17; unilateral/bilateral: 11/6), diplopia (n=2) and blurred vision (n=2).

None of the patients with TVL had new episodes after initiation of TCZ, while 11 out of 60 patients with PVL experienced some improvement (FIGURE). The two patients with diplopia and one of the two patients with blurred vision improved.

Conclusion: TCZ seems to prevent the appearance of new ocular manifestations. When they are present, TCZ may improve totally TVL and partially PVL.

Background/Purpose: One of the most feared complications of giant cell arteritis (GCA) is visual affection. Tocilizumab (TCZ) has demonstrated efficacy and safety in GCA. However, data on visual affection with TCZ are scarce and sometimes contradictory.

Our objectives were to evaluate the efficacy of TCZ in a)preventing the onset of new visual manifestations, and b)improving visual symptoms when present.

Methods: Multicenter observational study of 471 patients with GCA treated with TCZ of clinical practice. Patients were diagnosed with GCA according to a)ACR criteria, and/or b)temporal artery biopsy, and/or c)imaging techniques.

Patients were divided into 2 groups: a)with visual involvement at some time during the disease, and b)without visual involvement. Visual manifestations were classified as: a)transient visual loss (TVL) (amaurosis fugax), b)permanent visual loss (PVL) (more than 24 hours) (partial or complete; unilateral or bilateral), c)diplopia, and d)blurred vision. According to the duration between the onset of visual symptoms and the onset of TCZ we have considered a)1-10 days, b)11-30 days, and c)more than 30 days.

Results: We studied 471 (342 women/ 129 men; mean age: 74 ± 9 years). Visual manifestations at any time of the disease were observed in 122 (26%) patients. In 81 of them visual manifestations were present at TCZ onset, while the remaining 41 patients had had a complete recovery previously to TCZ. The main GCA features of patients with and without visual involvement are shown in TABLE. Patients with visual involvement were older, with other ischemic complications, and required higher doses of corticosteroids.

After starting TCZ, no patient developed new visual involvement. At TCZ onset, 81 patients had the following visual manifestations: PVL (n= 60; unilateral/bilateral: 48/12), TVL (n= 17; unilateral/bilateral: 11/6), diplopia (n=2) and blurred vision (n=2).

None of the patients with TVL had new episodes after initiation of TCZ, while 11 out of 60 patients with PVL experienced some improvement (FIGURE). The two patients with diplopia and one of the two patients with blurred vision improved.

Conclusion: TCZ seems to prevent the appearance of new ocular manifestations. When they are present, TCZ may improve totally TVL and partially PVL.

Disclosures: L. Sánchez-Bilbao, None; J. Loricera, None; J. Valdivieso Achá, 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; V. Pinillos, 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, Valdivieso Achá J, 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, Pinillos V, 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 the Visual Involvement of Giant Cell Arteritis: Multicenter Study of 471 Patients of Clinical Practice [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/effectiveness-of-tocilizumab-in-the-visual-involvement-of-giant-cell-arteritis-multicenter-study-of-471-patients-of-clinical-practice/. Accessed .

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