Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
To report the French experience on the efficacy and safety of tocilizumab (TCZ) in patients with giant cell arteritis (GCA) and outcome after treatment withdrawal.
A retrospective multicenter study included patients treated with TCZ for their GCA. Treatment efficacy was evaluated at a clinical and biological level. Side effects and outcome after treatment withdrawal were also recorded.
Thirty-four patients (27 women and 7 males) aged 70.5±8.2 (mean±SD) were included. Diagnosis of GCA was based on the ACR criteria (30 patients) and/or on imaging abnormalities suggestive of GCA (8 patients). Treatment included glucocorticoids in all patients and another immunosuppressant before TCZ introduction in 20/34 patients (59%). TCZ (8 mg/kg monthly) was prescribed after a mean disease duration of 18 months (0-107) and patients were treated for a mean of 6.4±4.5 months. It was effective in all but 6 patients who still had mild symptoms while CRP was reduced from 40.4±45.6 mg/L to 1.5±1.8 mg/L (p<0.0001) and glucocorticoids were tapered from 26.3±13.8 to 10.3±8.3 (p<0,0001). One patient died from septic shock and TCZ was stopped in 3 patients for severe adverse events (tuberculous pericarditis, liver cytolysis and neutropenia). Among the 23 patients who stopped treatment (planned medical decision in 2O cases, side effects in 3 cases) eight patients experienced relapses occurring after a mean of 3.5±1.3 months and TCZ was started again in 5 of them.
Under TCZ therapy, patients with GCA have a rapid and sustained improvement. However, side effects were noticeable and should be kept in mind in these patients. Questions remain regarding the suspensive nature of this treatment and this should be specifically addressed in future studies.
To cite this abstract in AMA style:Regent A, Redeker S, Deroux A, Kieffer P, Ly KH, Dougados M, Larroche C, Guillevin L, Bouillet L, Espitia O, Costedoat-Chalumeau N, Soubrier M, Brihaye B, Lifermann F, Lefèvre G, Puéchal X, Mouthon L, Toussirot E. Tocilizumab in Giant Cell Arteritis: A Multicentre Open-Label Study in France [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/tocilizumab-in-giant-cell-arteritis-a-multicentre-open-label-study-in-france/. Accessed September 19, 2019.
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