THU0439 Tocilizumab in giant cell arteritis. national multicenter study of 134 patients of clinical practice. (12th June 2018)

• Record Type: Journal Article
• Authors: Prieto-Peña, D.; Loricera, J.; Martín-V, J.; Calderón-G, M.; Aldasoro, V.; Varela-G, M.; Ibánez-B, R.; Villa, I.; Aurrecoechea, E.; Castañeda, S.; Humbría, A.; Díez, E.; Moriano, C.; Romero-Y, S.; Narváez, J.; Gómez-A, C.; Mera, A.; Pérez-P, E.; Dos Santos, R.; Barbazán, C.; Melero, R.; Becerra-F, E.; García, Á.; Revenga, M.; Larena, C.; Miguel, E.; Álvarez-R, N.; Galisteo, C.; Sivera, F.; Olivé-M, A.; Prior, A.; Álvarez, M.; Marena-R, L.; Fernández-L, C.; Navarro, F.; Raya, E.; Ortego, N.; Galíndez-A, E.; Arca, B.; Fernández, S.; Solans-L, R.; Conesa, A.; Hidalgo, C.; Vázquez, C.; Román-I, J.; Ortiz-S, F.; Lluch, P.; Manrique-A, S.; Vela, P.; Torres-M, C.; Nieto, J.; Ordas-C, C.; Salgado-P, E.; Gómez, C.; Toyos, J.; Hernández, I.; Maceiras-P, F.; Fernández-L, N.; García, A.; Palmou-F, N.; Calvo-R, V.; González-V, C.; Domínguez-C, L.; Corrales, A.; Hernández, J.; González-Gay, M.; Blanco, R.;
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 432
• Page End: 432
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.4096
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Giant cell arteritis (GCA) can be refractory to corticosteroids 1–3 . Tocilizumab (TCZ) demonstrated to be effective in two short-term clinical trials. Objectives: To assess efficacy of TCZ in refractory GCA or with side effects to corticosteroids in clinical practice. Methods: Multicenter study on 134 patients with GCA in treatment with TCZ due to lack of efficacy and/or unacceptable adverse events of previous therapy. Results: 134 patients (101 w/33 m); mean age of 73.0±8.8 years. Main clinical features at TCZ onset were: PMR (n=73), constitutional syndrome (n=31), headache (n=70), visual (n=28) and jaw (n=14) affection. Besides steroids, 98 patients also received immunosuppressive agents. table 1 shows evolution during follow-up period. After a median follow-up of 12 [3.7–24] months, it was observed a decrease in:a) CRP from 1.7 [0.4–3.2] to 0.1 [0.0–0.3] mg/dL b) ESR from 33 [14.5–61] to 4 2–9 mm/1st hour and c) Prednisone dose from 15 10–30 to 5 [0–7.5] mg/day. Outcome of patients was:a) discontinuation of TCZ (n=15) due to sustained remission, b) dose reduction due to improvement (n=17) or side effects (n=11), c) withdrawal of TCZ because of side effects (n=12) and d) same dose that at onset (n=73). TCZ had to be discontinued due to: infections, haematological and cardiovascular alterations, neoplasms and heptic toxicity among the most frequent. Table 1: Conclusions: TCZ 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. References: [1] Loricera J, et al. Semin Arthritis Rheum2015;44:717–723. [2] Loricera J, et al. Clin Exp Rheumatol2014;32(3Suppl82):S79–89. [3] Loricera J, et al. Clin Exp Rheumatol2016; 34 (3 Suppl 97):S44–53. Disclosure of Interest: None declared