Tocilizumab in Aortitis: A Multicenter Study of 79 Patients

Mónica Calderón-Goercke¹, Javier Loricera ², DIANA PRIETO- PENA ³, Vicente Aldasoro Caceres ⁴, Santos Castañeda ⁵, Ignacio Villa ⁶, Alicia Humbría ⁷, Clara Moriano ⁸, Susana Romero-Yuste ⁹, Javier Narváez ¹⁰, Catalina Gómez-Arango ¹¹, Eva Perez Pampín ¹², Rafael Melero ¹³, Marcelino Revenga ¹⁴, Noelia Álvarez-Rivas ¹⁵, Francisca Sivera ¹⁶, María Álvarez del buergo ¹⁷, Luisa Marena-Rojas ¹⁸, Eva Galindez-Agirregoikoa ¹⁹, Beatriz Arca ²⁰, Roser Solans-Laqué ²¹, Carlos Vazquez ²², Pau Lluch ²³, Eva salgado-Pérez ²⁴, Cristina Luna-Gómez ²⁵, F. Javier Toyos-Sáenz De Miera ²⁶, Nagore Fernández-Llanio ²⁷, Antonio García ²⁸, Carmen Larena ²⁹, Lara Sanchez-Bilbao ¹, Iñigo Gonzalez-Mazon ³, Natalia Palmou-Fontana ³, Vanesa Calvo-Río ¹, Carmen González-Vela ¹, Alfonso Corrales ³⁰, María Varela-García ⁴, Elena Aurrecoechea ⁶, Raquel Dos Santos ³¹, Sabela Fernández ²⁰, Jose Luis Hernández ¹, Miguel Angel González-Gay ³² and Ricardo Blanco ³³, ¹Hospital Marqués de Valdecilla, Santander, Cantabria, Spain, ²Rheumatology Department. Hospital Marqués de Valdecilla, Santander, Cantabria, Spain, ³Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain, ⁴Complejo Hospitalario de Navarra, Navarra, Navarra, Spain, ⁵Rheumatology Department, Hospital Universitario de la Princesa, IIS-Princesa, Madrid, Spain, Madrid, Spain, ⁶Hospital de Sierrallana, Torrelavega, Cantabria, Spain, ⁷Hospital de La Princesa, Madrid, Madrid, Spain, ⁸Complejo Asistencial Universitario de León, León, Castilla y Leon, Spain, ⁹Complejo Hospitalario Universitario Pontevedra, Pontevedra, Galicia, Spain, ¹⁰Rheumatology Department, Hospital Universitario de Bellvitge, Barcelona, Spain, Barcelona, Catalonia, Spain, ¹¹Hospital Alto Deba, Mondragon, Pais Vasco, Spain, ¹²Division of Rheumatology, Instituto de Investigación Sanitaria-Hospital Clinico Universitario de Santiago, Santiago de Compostela, Spain, Santiago de Compostela, Spain, ¹³Complexo Hospitalario Universitario de Vigo, Vigo, Galicia, Spain, ¹⁴Hospital Ramón y Cajal, Madrid, Madrid, Spain, ¹⁵Hospital Universitario Lucus Augusti, Lugo, Galicia, Spain, ¹⁶Hospital General Universitario de Elda, Elda, Spain, ¹⁷Hospital Río Carrión, Palencia, Castilla y Leon, Spain, ¹⁸Hospital La Mancha Centro, Alcázar de San Juan, Castilla-La Mancha, Spain, ¹⁹Hospital de Basurto, Bilbao, Pais Vasco, Spain, ²⁰Hospital Universitario San Agustín, Avilés, Asturias, Spain, ²¹Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain., Barcelona, Catalonia, Spain, ²²Hospital Miguel Servet, Zaragoza, Aragon, Spain, ²³Hospital Mateu Orfila, Menorca, Islas Baleares, Spain, ²⁴Complejo Hospitalario Universitario de Ourense, Ourense, Galicia, Spain, ²⁵Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Canarias, Spain, ²⁶Hospital Universitario Virgen Macarena, Sevilla, Andalucia, Spain, ²⁷Hospital Arnau de Vilanova, Lérida, Catalonia, Spain, ²⁸Hospital Virgen de las Nieves, Granada, Andalucia, Spain, ²⁹Hospital Universitario Ramón y Cajal, Madrid, Madrid, Spain, ³⁰Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, IDIVAL, Santander, Spain, Santander, Spain, ³¹Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Galicia, Spain, ³²Universidad de Cantabria and IDIVAL, Hospital Universitario Marqués de Valdecilla, Santander, Spain, ³³Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Spain

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: aortitis, tocilizumab and efficacy

Session Information

Date: Monday, November 11, 2019

Title: Imaging Of Rheumatic Diseases Poster II

Session Type: Poster Session (Monday)

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

Background/Purpose: Aortitis can be idiopathic or associated with other conditions. It is frequently refractory to conventional immunosuppressive therapy. Tocilizumab (TCZ), an anti-IL-6 receptor antibody seems to be effective and safe.
Our aim was to assess the efficacy and safety of TCZ at short and long follow-up in a series of patients with Aortitis.

Methods: Retrospective, multicenter study of 79 patients diagnosed of inflammatory aortitis based on imaging techniques (PET/CT, CT angiography and/or MR angiography).

Results: We study 79 patients (61 w/ 18 m). 59 (74.7%) cases were Aortitis secondary to Giant Cell Arteritis (GCA), while 20 (25.3%) were idiopathic. The mean age was 71±8.5 years vs 64.2±7.1 years, respectively (p=0.001). At time of disease diagnosis more than a half of patients (59.5%) presented as main symptom polymyalgia rheumatica (PMR). Aortitis was diagnosed with PET/CT (71 patients), angioRMN (12 patients) and angioCT (8 patients). Prior to TCZ treatment, 61 (77.2%) patients had received conventional immunosuppressive drugs, 59 (74.7%) of them received MTX. After 24 months of treatment with TCZ, more than 75% of patients reached a prolonged remission in both groups (p=0.527), with only 4% of relapses after the same follow-up period (p=1.000). 40 (50.6%) patients had a control image technique (PET/CT) throughout follow up. 4 (3 secondary to GCA and 1 idiopathic) patients reached a complete improvement in uptake after one year of treatment.

Conclusion: Our results show that idiopathic aortitis occurs in younger patients compared with aortitis secondary to GCA. TCZ proved to be effective in both pathologies, allowing clinical and analytical improvement, as well as a reduction of corticoid dose, without increasing the risk of relapse. However, the improvement in imaging techniques seems to be slower.

TABLE Aortitis

Disclosure: M. Calderón-Goercke, None; J. Loricera, None; D. PRIETO- PENA, None; V. Aldasoro Caceres, None; S. Castañeda, None; I. Villa, None; A. Humbría, None; C. Moriano, None; S. Romero-Yuste, None; J. Narváez, None; C. Gómez-Arango, None; E. Perez Pampín, None; R. Melero, None; M. Revenga, None; N. Álvarez-Rivas, None; F. Sivera, None; M. Álvarez del buergo, None; L. Marena-Rojas, None; E. Galindez-Agirregoikoa, None; B. Arca, None; R. Solans-Laqué, None; C. Vazquez, None; P. Lluch, None; E. salgado-Pérez, None; C. Luna-Gómez, None; F. Toyos-Sáenz De Miera, None; N. Fernández-Llanio, None; A. García, None; C. Larena, None; L. Sanchez-Bilbao, None; I. Gonzalez-Mazon, None; N. Palmou-Fontana, None; V. Calvo-Río, None; C. González-Vela, None; A. Corrales, None; M. Varela-García, None; E. Aurrecoechea, None; R. Dos Santos, None; S. Fernández, None; J. Hernández, None; M. González-Gay, AbbVie, 2, 5, 8, Abbvie, 2, 5, 8, Celgene, 5, 8, Eli Lilly, 2, 5, EliLilly, 2, 5, Jansen, 2, Janssen, 2, MSD, 2, 5, 8, Novartis, 2, 5, Pfizer, 5, 8, Roche, 2, 5, 8, Sanofi, 2, 5, 8, Sobi, 5, 8; R. Blanco, None.

To cite this abstract in AMA style:

Calderón-Goercke M, Loricera J, PRIETO- PENA D, Aldasoro Caceres V, Castañeda S, Villa I, Humbría A, Moriano C, Romero-Yuste S, Narváez J, Gómez-Arango C, Perez Pampín E, Melero R, Revenga M, Álvarez-Rivas N, Sivera F, Álvarez del buergo M, Marena-Rojas L, Galindez-Agirregoikoa E, Arca B, Solans-Laqué R, Vazquez C, Lluch P, salgado-Pérez E, Luna-Gómez C, Toyos-Sáenz De Miera F, Fernández-Llanio N, García A, Larena C, Sanchez-Bilbao L, Gonzalez-Mazon I, Palmou-Fontana N, Calvo-Río V, González-Vela C, Corrales A, Varela-García M, Aurrecoechea E, Dos Santos R, Fernández S, Hernández J, González-Gay M, Blanco R. Tocilizumab in Aortitis: A Multicenter Study of 79 Patients [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/tocilizumab-in-aortitis-a-multicenter-study-of-79-patients/. Accessed .

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