ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 780

Short and Long-Term Follow-up with Tocilizumab in Giant Cell Arteritis. National Multicenter Study of 49 Patients of Clinical Practice

Lucia C. Domínguez-Casas1, Javier Loricera1, Jose L. Hernández2, Santos Castañeda3, Vicente Aldasoro4, María Varela-García5, Rosario Ibañez-Bosch5, Antonio Mera6, Eva Pérez-Pampin6, Alicia Humbría7, Jaime Calvo-Alén8, Elena Aurrecoechea9, Javier Narváez10, Amalia Sánchez-Andrade11, Paloma Vela12, Elvira Diez Alvarez13, Clara Moriano14, Cristina Mata15, Pau Lluch16, Concepción Moll17, Íñigo Hernández-Rodríguez18, Vanesa Calvo-Río1, José Andrés Román-Ivorra19, Carlos Vazquez20, Alfonso Corrales1, MC Gonzalez-Vela21, Francisco Ortiz-Sanjuán22, Belén Atienza-Mateo1, José Luis Martín-Varillas1, Miguel Angel González-Gay23 and Ricardo Blanco1, 1Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 2Internal Medicine, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 3Hospital Universitario La Princesa. IIS-IP. Madrid. Spain, Madrid, Spain, 4Hospital Alto Deba. Mondragón. Spain, Mondragon, Spain, 5Rheumatology, Complejo Hospitalario de Navarra. Navarra. Spain, Navarra, Spain, 6Rheumatology, Complejo Hospitalario Universitario de Santiago. Galicia. Spain, Santiago de Compostela, Spain, 7Rheumatology, Hospital Universitario La Princesa. IIS-IP. Madrid. Spain, Madrid, Spain, 8Rheumatology, Hospital de Sierrallana. Torrelavega. Cantabria. Spain, Alava, Spain, 9Rheumatology, Hospital de Sierrallana, Torrelavega. Cantabria. Spain, Torrelavega, Spain, 10Rheumatology Department, Hospital de Bellvitge. Barcelona. Spain, L’Hospitalet de Llobregat, Spain, 11Hospital Universitario Lucus Augusti. Lugo. Spain, Lugo, Spain, 12Reumatología, Hospital General Universitario de Alicante. Alicante. Spain, Alicante, Spain, 13Complejo Asistencial Universitario de León. León. Spain, León, Spain, 14Rheumatology, Complejo Asistencial Universitario de León. León. Spain, Leon, Spain, 15Rheumatology, Hospital de Laredo. Laredo. Spain, Laredo, Spain, 16Rheumatology, Hospital Mateu Orfila. Menorca. Spain, Menorca, Spain, 17Rheumatology., Hospital Mateu Orfila. Menorca. Spain, Menorca, Spain, 18Rheumatology, CHUVI Vigo. Galicia. Spain, Vigo, Spain, 19Rheumatology, Hospital Universitario La Fe. Valencia. Spain, Valencia, Spain, 20Rheumatology, Hospital Miguel Servet. Zaragoza. Spain, Zaragoza, Spain, 21Pathology Anatomy, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 22Rheumatology., Hospital Universitario La Fe. Valencia. Spain, Valencia, Spain, 23Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Johannesburg, South Africa

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: giant cell arteritis, tocilizumab and vasculitis

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Sunday, November 5, 2017

Session Title: Vasculitis Poster I: Large Vessel Vasculitis

Session Type: ACR Poster Session A

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

Background/Purpose: Randomized clinical trial has shown the efficacy of tocilizumab (TCZ) in Giant cell arteritis (GCA). However this data are of selected cases of clinical trial and only a short follow-up have been published. Our aim was to assess the short and long-term efficacy/side effects in clinical practice

Methods: Multicenter open-label study on 49 GCA patients treated with TCZ [iv; 8 mg/kg/monthly (n=45), and subcutaneously; 162 mg/week (n=4)]. We assessed the short and long-term efficacy/safety and the optimization of TCZ dose.

Results: We included 49 patients (39 women/10 men), mean age 73±9 years. The main clinical features at TCZ onset were: polymyalgia rheumatica (n=31), headache (25), asthenia (17), constitutional syndrome (15), jaw claudication (5), and visual loss (6). Besides corticosteroids and before TCZ, 43 patients had also received several conventional immunosuppressive and/or biologic drugs. 45 of 49 patients achieved a rapid and maintained clinical improvement after TCZ (Table). After a median follow-up of 18 [IQR, 7-28] months we observe a reduction of the median of: a) C-reactive protein; b) ESR; and c) prednisone dose. In this follow-up period, the outcome of patients was as follows: a) discontinuation of TCZ due to sustained remission(n=8); b) dose reduction due to improvement (8) or side effects (4); c) withdrawal of TCZ because of side effects (9); and d) the same dose that at onset (19). TCZ was discontinued due to: severe neutropenia; recurrent pneumonia; colon adenocarcinoma; cytomegalovirus infection; Alzheimer´s disease and atrioventricular blockade; hypertensive crisis during infusion; myelodysplastic syndrome; colon neoplasm and overall health deterioration. The latter patient died because of stroke. Another patient also died after the second TCZ infusion due to stroke in the context of an infective endocarditis. In another one, the dose had to be reduced by recurrent urinary tract infection. In other two patients TCZ was reduced because of moderate neutropenia (one of them also developed cellulitis) and another patient developed diverticulitis.

Conclusion: TCZ therapy leads to a rapid and maintained improvement in patients with refractory GCA and/or with unacceptable side effects related to corticosteroids. However, the risk of neutropenia and infection should be kept in mind when using this biologic agent in patients with GCA

TABLE

Baseline

Month 6

Month 12

Month 18

Month 24

Clinical improvement, % (n)

100 (43/43)**

97 (32/33)**

91 (20/22)**

100 (16/16)*

Laboratory markers, median [IQR]

ESR (mm/1st/h)

43 [18-66] (46)

16 [2-5]** (38)

5 [2-8.5]** (28)

2 [2-15.5]** (20)

6 [2-12.5]** (16)

CRP (mg/dl)

1.9 [1.1-3.2] (49)

0.1 [0.1-0.2]** (41)

0.1 [0.1-0.3]** (29)

0.1 [0.1-0.6]* (18)

0.2 [0.1-0.3]** (16)

Dose of corticosteroids, median [IQR]

15 [10-30] (49)

5 [2.5-7.5] (47)

2.5 [0-5] (33)

2.5 [0-5] (23)

2.5 [0-5.6] (17)


The number of patients with available data is shown in parentheses

* p <0.05 ** p < 0.01 vs. baseline (Wilcoxon test)The number of patients with available data is shown in parentheses


Disclosure: L. C. Domínguez-Casas, None; J. Loricera, None; J. L. Hernández, None; S. Castañeda, None; V. Aldasoro, None; M. Varela-García, None; R. Ibañez-Bosch, None; A. Mera, None; E. Pérez-Pampin, None; A. Humbría, None; J. Calvo-Alén, None; E. Aurrecoechea, None; J. Narváez, None; A. Sánchez-Andrade, None; P. Vela, None; E. Diez Alvarez, None; C. Moriano, None; C. Mata, None; P. Lluch, None; C. Moll, None; Í. Hernández-Rodríguez, None; V. Calvo-Río, None; J. A. Román-Ivorra, None; C. Vazquez, None; A. Corrales, None; M. Gonzalez-Vela, None; F. Ortiz-Sanjuán, None; B. Atienza-Mateo, None; J. L. Martín-Varillas, None; M. A. González-Gay, None; R. Blanco, None.

To cite this abstract in AMA style:

Domínguez-Casas LC, Loricera J, Hernández JL, Castañeda S, Aldasoro V, Varela-García M, Ibañez-Bosch R, Mera A, Pérez-Pampin E, Humbría A, Calvo-Alén J, Aurrecoechea E, Narváez J, Sánchez-Andrade A, Vela P, Diez Alvarez E, Moriano C, Mata C, Lluch P, Moll C, Hernández-Rodríguez Í, Calvo-Río V, Román-Ivorra JA, Vazquez C, Corrales A, Gonzalez-Vela M, Ortiz-Sanjuán F, Atienza-Mateo B, Martín-Varillas JL, González-Gay MA, Blanco R. Short and Long-Term Follow-up with Tocilizumab in Giant Cell Arteritis. National Multicenter Study of 49 Patients of Clinical Practice [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/short-and-long-term-follow-up-with-tocilizumab-in-giant-cell-arteritis-national-multicenter-study-of-49-patients-of-clinical-practice/. Accessed April 17, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/short-and-long-term-follow-up-with-tocilizumab-in-giant-cell-arteritis-national-multicenter-study-of-49-patients-of-clinical-practice/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.