Tocilizumab in Extracranial Large-Vessel Giant Cell Arteritis and Takayasu Arteritis: A Multicentric Observational Comparative Study

Carmen Lasa Teja¹, Javier Loricera², Diana Prieto-Peña³, fernando lopez gutierrez⁴, Pilar Bernabéu⁵, Mercedes Freire González⁶, ivan Ferraz-Amaro⁷, Santos Castañeda⁸, Mauricio Mínguez⁹, Beatriz bravo-Mancheño¹⁰, Roser Solans-Laqué¹¹ and Ricardo Blanco-Alonso¹², ¹Hospital Universitario Marqués de Valdecilla, Riotuerto, Spain, ²Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, ³Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Cantabria, Spain, ⁴Rheumatology, madrid, Madrid, Spain, ⁵Rheumatology section, Dr. Balmis General University Hospital-ISABIAL, Alicante, Spain, Alicante, Spain, ⁶Complexo Hospitalario Universitario de A Coruña, La coruna, Galicia, Spain, ⁷Rheumatology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Canarias, Spain, ⁸Hospital Universitario de la Princesa, Madrid, Spain, ⁹Hospital San Juan de Alicante, Rheumatology., Alicante, Spain, ¹⁰Hospital Universitario Virgen de las Nieves, Granada, Granada., Spain, ¹¹Internal Medicine Service, Vall d'Hebron Hospital University and Campus, Barcelona, Spain, ¹²Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Spain

Meeting: ACR Convergence 2024

Keywords: Biologicals, corticosteroids, giant cell arteritis, Takayasu.s arteritis, Vasculitis

Session Information

Date: Saturday, November 16, 2024

Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster I

Session Type: Poster Session A

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

Background/Purpose: Tocilizumab (TCZ) seems to be effective in large vessel (LV) vasculitis including giant cell arteritis (GCA) and Takayasu arteritis (TAK). LV-GCA phenotype shares some features with TAK, but also shows differences that may influence the TCZ therapeutic response.

Methods: A comparative observational multicenter study between LV-GCA (n=70) and TAK (n=57) patients treated with TCZ was conducted. Outcome variables were assessed at baseline, 1, 3, 6 and 12 months after TCZ and included: a) clinical remission and laboratory markers improvement; b) imaging improvement; c) GC-sparing effect; and d) safety analysis.

Results: At TCZ initiation, TAK patients were younger, had longer disease duration, prior exposure to more biologics, and were on higher prednisone doses. Although an initial slower clinical clinical remission was observed in TAK patients, similar rates were observed at 12 months (74.5% and 76.9% of LV-GCA and TAK, respectively). A rapid improvement of laboratory markers and GC-sparing effect was observed in both groups. However, complete imaging improvement was only observed in 18.9% and 21.1% of LV-GCA and TAK patients. Safety data were similar in both groups. TCZ discontinuation due to severe infections occurred in 4 LV-GCA and three TAK patients.

Conclusion: In a real-world setting, TCZ showed comparable effectiveness in achieving remission and GC-sparing effects in LV-GCA and TAK. A discordance between clinical and imaging activity improvement was observed in both groups.

Table 1. Main clinical features of patients with refractory extracranial LV-GCA and TAK at TCZ initiation.

Figure 1. (A) Remission (clinical and analytic) and remission by imagen techniques at 12 months os follow-up. (B) Evolution of CRP (mg/dl) in patients with extracranial LV-GCA and TAK at 1, 3, 6 and 12 months after Tocilizumab initiation and C) prednisone doce (mg/day).
*p<0.001 vs baseline values. Significant differences between both groups were expressed as +.

Disclosures: C. Lasa Teja: 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; D. Prieto-Peña: None; f. lopez gutierrez: None; P. Bernabéu: None; M. Freire González: None; i. Ferraz-Amaro: AbbVie/Abbott, 5, 6, Celgene, 6, Janssen, 5, Merck/MSD, 5, 6, Pfizer, 6, Roche, 5, 6, sanofi, 6; 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; M. Mínguez: None; B. bravo-Mancheño: None; R. Solans-Laqué: CSL-Vifor, 2, 6, GlaxoSmithKlein(GSK), 2, 6, Menarini, 12, Support for attending meetings; 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:

Lasa Teja C, Loricera J, Prieto-Peña D, lopez gutierrez f, Bernabéu P, Freire González M, Ferraz-Amaro i, Castañeda S, Mínguez M, bravo-Mancheño B, Solans-Laqué R, Blanco-Alonso R. Tocilizumab in Extracranial Large-Vessel Giant Cell Arteritis and Takayasu Arteritis: A Multicentric Observational Comparative Study [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/tocilizumab-in-extracranial-large-vessel-giant-cell-arteritis-and-takayasu-arteritis-a-multicentric-observational-comparative-study/. Accessed .

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