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Abstract Number: 1106

Factors Associated with Relapse in Giant Cell Arteritis Treated with Tocilizumab. Multicenter Open-label Study of 407 Patients

Adrián Martín-Gutiérrez1, Javier Loricera2, Carmen Secada Gómez3, Clara Moriano4, Javier Narvaez-García5, Vicente Aldasoro6, Olga Maíz Alonso7, Iñigo Hernández-Rodríguez8, Paloma Vela-Casasempere9, Susana Romero Yuste10, Eugenio De Miguel11, Eva Galindez-Agirregoikoa12, Jesus C. Fernandez-López13, ivan Ferraz-Amaro14, Julio Sánchez-Martín15, José Luis Callejas16, Patricia Moya Albarado17, Cristina Campos Fernández18, Fernando Lopez-Gutierrez19, Santos Castañeda20 and Ricardo Blanco-Alonso21, and the Tocilizumab in Giant Cell Arteritis Spanish Collaborative Group, 1Hospital Universitario Marques de Valdecilla, IDIVAL, Renedo de Piélagos, Cantabria, Spain, 2Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, 3Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, 4Hospital León, LEON, Spain, 5Hospital Universitario de Bellvitge, Barcelona, Spain, 6Hospital Universitario de Navarra, Pamplona, Spain, 73Hospital Universitario de Donosti, San Sebastian, Spain, San Sebastian, Pais Vasco, Spain, 8Complejo Hospitalario Universitario de Vigo, Vigo, Spain, 9Hospital General Universitario Alicante, Alicante, Spain, 10Department of Rheumatology, University Hospital Complex of Pontevedra, Pontevedra, Spain, 11Hospital Universitario La Paz, Madrid, Spain, 12BASURTO UNIVERSITY HOSPITAL, BILBAO, Spain, 1311Rheumatology, Hospital Universitario Juan Canalejo, A Coruña, Spain., A Coruña, Spain, 14Rheumatology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Canarias, Spain, 15Hospital Universitario 12 de Octubre, Madrid, Spain, 16Systemic Autoimmune Diseases Unit, Hospital Clinico San Cecilio, Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Granada, Spain, 17Hospital de San Pau, Barcelona, Spain, 18Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain, 19Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain, 20Hospital Universitario de la Princesa, Madrid, Spain, 21Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Spain

Meeting: ACR Convergence 2024

Keywords: Biologicals, giant cell arteritis, risk factors, Vasculitis

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Session Information

Date: Sunday, November 17, 2024

Title: Miscellaneous Rheumatic & Inflammatory Diseases Poster II

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: Tocilizumab (TCZ) is the only biological drug approved for the treatment of giant cell arteritis (GCA). Clinical trials were performed with intravenous (IV) and subcutaneous (SC) TCZ in a phase-2, and phase-3 (GiACTA) studies, respectively. Interestingly, around a quarter of GCA patients have a relapse during TCZ treatment. Our aim was to assess the factors associated with relapses in a wide series of GCA patients in a real-world setting.

Methods: Multicenter observational study of 407 patients with GCA treated with TCZ. The diagnosis of GCA was performed between 2016 and 2021 according to: a) 1990 ACR criteria, b) temporal artery biopsy, and/or c) imaging evaluation techniques. The variables collected at TCZ initiation were demographics, clinical manifestations, laboratory, temporal artery biopsy, imaging findings, prednisone-equivalent dose and previous therapies. Patients with and without relapses were compared in a bivariate analysis. Multivariate logistic regression was performed to determine factors associated with relapse.

Results: After a mean follow-up of 25.3±21.7 months, GCA relapses were observed in 63 of 407 (15.5%) patients. No significant differences were observed between both groups (with/without relapses) in demographic, clinical and laboratory characteristics or in prednisone dose at initiation of TCZ. Interestingly, the set of variables associated with GCA relapses were: use of IV TCZ, combination of TCZ, optimization of TCZ and TCZ initiation ≥6 months after diagnosis. (Figure 1,2)

Conclusion: GCA relapse seems related mainly to TCZ schedule including IV use, combination use of TCZ, as well as, optimization of TCZ and initiation of TCZ after 6 months of diagnosis.

Supporting image 1

Abbreviations (in alphabetical order): bDMARDs: biological disease-modifying antirheumatic drugs; cGCA: cranial giant cell arteritis (GCA); CRP: C-reactive protein; ecGCA: extracranial; ESR: erythrocyte sedimentation rate; Hb: haemoglobin; IQR: interquartile range; IV: intravenous; n: number; PMR: polymyalgia rheumatica; scIS: synthetic conventional immunosuppressant drugs; SC: subcutaneous; SD: standard deviation; TCZ: tocilizumab. Statistical significance is specified as bold characters.

Supporting image 2

Abbreviations (in alphabetical order): Hb: hemoglobin; IV: intravenous; SC: subcutaneous; TCZ: tocilizumab.
Results were adjusted by the variables: “age at TCZ initiation”, “fever at TCZ initiation”, “previous/current smoking history at TCZ initiation”, “Hb at TCZ initiation”. Statistical significance is specified as bold characters.


Disclosures: A. Martín-Gutiérrez: None; J. Loricera: AstraZeneca, 2, 6, Celgene, 2, 6, Eli Lilly, 5, Janssen, 5, Merck/MSD, 2, 5, 6, Novartis, 12, Formation/Congress attendance, Pfizer, 5, Roche, 2, 5, 6, UCB, 2, 5, 6; C. Secada Gómez: None; C. Moriano: None; J. Narvaez-García: None; V. Aldasoro: None; O. Maíz Alonso: None; I. Hernández-Rodríguez: None; P. Vela-Casasempere: None; S. Romero Yuste: AstraZeneca, 5; E. De Miguel: AbbVie/Abbott, 5, 6, BMS, 5, 6, Eli Lilly, 5, 6, Grunental, 5, 6, Janssen, 5, 6, Merck/MSD, 5, 6, Novartis, 5, 6, Pfizer, 5, 6, Roche, 5, 6, sanofi, 5, 6, UCB, 5, 6; E. Galindez-Agirregoikoa: AbbVie/Abbott, 6, Amgen, 6, Eli Lilly, 6, Janssen, 6, Novartis, 6, Pfizer, 6, UCB, 6; J. Fernandez-López: None; i. Ferraz-Amaro: AbbVie/Abbott, 5, 6, Celgene, 6, Janssen, 5, Merck/MSD, 5, 6, Pfizer, 6, Roche, 5, 6, sanofi, 6; J. Sánchez-Martín: None; J. Callejas: None; P. Moya Albarado: None; C. Campos Fernández: None; F. Lopez-Gutierrez: AstraZeneca, 12, Formation/Congress attendance, 12, Formation/Congress attendance, Novartis, 12, Formation/congress attendance; S. Castañeda: Bristol-Myers Squibb(BMS), 2, 6, Eli Lilly, 2, 6, Merck/MSD, 2, 5, 6, Pfizer, 5, Roche, 2, 6, UCB, 2, 5; R. Blanco-Alonso: AbbVie, 2, 5, 6, Bristol-Myers Squibb, 2, 6, Galapagos, 6, Janssen, 2, 6, Lilly, 2, 6, MSD, 2, 5, 6, Pfizer, 2, 6, Roche, 2, 5, 6.

To cite this abstract in AMA style:

Martín-Gutiérrez A, Loricera J, Secada Gómez C, Moriano C, Narvaez-García J, Aldasoro V, Maíz Alonso O, Hernández-Rodríguez I, Vela-Casasempere P, Romero Yuste S, De Miguel E, Galindez-Agirregoikoa E, Fernandez-López J, Ferraz-Amaro i, Sánchez-Martín J, Callejas J, Moya Albarado P, Campos Fernández C, Lopez-Gutierrez F, Castañeda S, Blanco-Alonso R. Factors Associated with Relapse in Giant Cell Arteritis Treated with Tocilizumab. Multicenter Open-label Study of 407 Patients [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/factors-associated-with-relapse-in-giant-cell-arteritis-treated-with-tocilizumab-multicenter-open-label-study-of-407-patients/. Accessed .
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