Serological Immune-Inflammatory Markers of the First RCT about Tocilizumab to Treat Giant Cell Arteritis

Andrea Gloor¹, Daniel Yerly², Stefan Kuchen³, Sabine Adler⁴, Stephan Reichenbach¹, Michael Seitz⁵ and Peter M. Villiger⁶, ¹Rheumatology, University hospital, Bern, Switzerland, ²Rheumatology, Uiversity hospital, Bern, Switzerland, ³Department of Rheumatology, Immunology and Allergology, University Hospital Bern, Bern, MD, Switzerland, ⁴Rheumatology, University Hospital Bern, Bern, Switzerland, ⁵Rheumatology, Clinical Immunology & Allergology, University Hospital, Bern, Switzerland, ⁶Rheumatology, Immunology and Allergology, University Hospital Bern, Bern, Switzerland

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: giant cell arteritis, therapeutic targeting, tocilizumab and vasculitis

Session Information

Date: Sunday, November 5, 2017

Title: Vasculitis Poster I: Large Vessel Vasculitis

Session Type: ACR Poster Session A

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

Background/Purpose: As published in The Lancet online, March 4, 2016, the first randomized, placebo-controlled trial (RCT) about tocilizumab (TCZ) in giant cell arteritis (GCA) showed clinical efficacy of the anti-IL-6R biologic agent in the induction and maintenance of remission for 52 weeks (ClinicalTrials.gov registration number: NCT01450137). So far nothing is known about the profile of biomarkers in complete remission controlled by TCZ. In this study we compared a large variety of biomarkers in complete remission induced by TCZ plus glucocorticoids (GC; early phase of the study) versus complete remission induced by TCZ monotherapy (late phase of the study), and we compared the data with age-matched healthy controls.

Methods:

Serum levels of 18 biomarkers were quantified using Multiplex technology (R&DSystems and Invitrogen) at weeks 0, 4, 12 and 52 of the RCT. TCZ concentrations were determined by QPS, Groningen, The Netherlands. Sex and age matched healthy individuals were included as controls (CTRL).

Results: TCZ plasma concentrations reached a plateau by week 20. Several molecules did not display a discrete pattern over time (sCD25, adiponectin, resistin, leptin, BAFF, IFNa, YKL-40, TNF-R2, hsCRP, sICAM-1, CD163) or remained undetectable (IL17a, IL28A, Il-11, IL-20, VCAM-1). MMP-3 and Pentraxin-3 showed a decline over time and reached almost normal values at the end of the study. Their concentrations correlated with TCZ plasma levels and inversely with GC dose. None of the parameters predicted flare after study end.

Conclusion: The analysis of a wide variety of immune-inflammatory markers documents a persistent subclinical disease activity during co-medication of TCZ and GC, but a near normalization of most values under TCZ monotherapy. In conclusion the results corroborate the advantage of anti-IL-6R therapy over GCs.

Disclosure: A. Gloor, None; D. Yerly, None; S. Kuchen, None; S. Adler, None; S. Reichenbach, None; M. Seitz, None; P. M. Villiger, None.

To cite this abstract in AMA style:

Gloor A, Yerly D, Kuchen S, Adler S, Reichenbach S, Seitz M, Villiger PM. Serological Immune-Inflammatory Markers of the First RCT about Tocilizumab to Treat Giant Cell Arteritis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/serological-immune-inflammatory-markers-of-the-first-rct-about-tocilizumab-to-treat-giant-cell-arteritis/. Accessed .

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