Session Type: Poster Session (Tuesday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Tocilizumab (TCZ) has been approved for the treatment of Giant Cell Arteritis (GCA). It showed to be effective to induce remission, prevent relapses and decrease the cumulative prednisone dose. However, the glucocorticoids are the mainstay in the acute treatment of GCA.
Our aim was to compare the efficacy and safety of the initial dose of prednisone at the onset of TCZ treatment.
Methods: Retrospective, multicenter study on 134 patients with GCA in treatment with TCZ. We compared two subgroups of patients according to the initial dose of prednisone at TCZ onset. Clinical efficacy, analytical improvement and safety was studied.
Results: We studied 134 patients (101 w/33 m) and made a comparative study between 2 groups: a) TCZ and ≤ 15 mg of prednisone; 68 (50.7%) cases, and b) TCZ and > 15 mg of prednisone, 66 (49,3%) patients. It is summarized in TABLE 1. It was no statistical significance according to age, sex and evolution time of disease. In the group receiving > 15 mg of prednisone, the patients presented more visual involvement (p< 0.001) at TCZ onset. In terms of prolonged remission and relapses no significant difference was seen between both groups. The risk of presenting adverse effects (11.8% vs 36.4%) and severe infections (4.4% vs 19.7%) was related with the prednisone dose, being more frequent in the group with > 15 mg of prednisone (p=0.001 and p=0.006, respectively). In TABLE 2 summarizes the infections of our patients.
Conclusion: According with our results, we can conclude that TCZ is equally effective; in terms of prolonged remission and relapses, with doses ≤ 15 mg of prednisone at treatment onset. Being the most important data, the higher risk to develop adverse effects, as well as infections with higher doses of prednisone.
To cite this abstract in AMA style:Calderón-Goercke M, Loricera J, PRIETO- PENA D, Castañeda S, Aldasoro Caceres V, Villa I, Humbría A, Moriano C, Romero-Yuste S, Narváez J, Gómez-Arango C, Perez Pampín E, Melero R, Becerra-Fernández E, Revenga M, Álvarez-Rivas N, Galisteo C, Sivera F, Olivé-Marqués A, Álvarez del buergo M, Marena-Rojas L, Fernández-López C, Navarro F, Raya E, Galindez-Agirregoikoa E, Arca B, Solans-Laqué R, Conesa A, Hidalgo C, Vazquez C, Román-Ivorra J, Lluch P, Manrique S, Vela P, de Miguel E, Torres-Martín C, Nieto J, Ordas-Calvo C, salgado-Pérez E, Luna-Gómez C, Toyos-Sáenz De Miera F, Fernández-Llanio N, García A, Aurrecoechea E, Ortego N, Ortiz-Sanjuán F, Corteguera M, Hernández J, González-Gay M, Blanco R. Tocilizumab in Giant Cell Arteritis: The Safest and Most Effective Initial Dose of Prednisone [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/tocilizumab-in-giant-cell-arteritis-the-safest-and-most-effective-initial-dose-of-prednisone/. Accessed May 16, 2022.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/tocilizumab-in-giant-cell-arteritis-the-safest-and-most-effective-initial-dose-of-prednisone/