Tocilizumab in Giant Cell Arteritis: A Multicenter Retrospective Study of 34 Patients

2016 ◽  
Vol 43 (8) ◽  
pp. 1547-1552 ◽  
Author(s):  
Alexis Régent ◽  
Serge Redeker ◽  
Alban Deroux ◽  
Pierre Kieffer ◽  
Kim Heang Ly ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Adverse Events ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Multicenter Study ◽  
Efficacy And Safety ◽  
Severe Adverse Events ◽  
Retrospective Multicenter Study

Objective.To report the efficacy and safety of tocilizumab (TCZ) for giant cell arteritis (GCA).Methods.A retrospective multicenter study that included 34 patients receiving TCZ for GCA.Results.TCZ was effective in all but 6 patients, who still had mild symptoms. Mean glucocorticoid dose was tapered. One patient died and 3 patients had to stop TCZ therapy because of severe adverse events. Twenty-three patients stopped treatment; 8 of these experienced relapses after a mean of 3.5 ± 1.3 months.Conclusion.TCZ is effective in GCA. However, side effects occur. Whether this treatment has only a suspensive effect remains to be determined.

scholarly journals Assessment of the efficacy and safety of tocilizumab in patients over 80 years old with giant cell arteritis

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Hubert de Boysson ◽  
◽  
Maelle Le Besnerais ◽  
Félix Blaison ◽  
Aurélie Daumas ◽  
...  
Keyword(s):  
Adverse Events ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Fold Increase ◽  
Study Group ◽  
Efficacy And Safety ◽  
Mesenteric Infarction ◽  
French Study ◽  
Sparing Effect

Abstract Objective To assess the efficacy and tolerance of tocilizumab (TCZ) in giant cell arteritis (GCA) patients over 80. Method GCA patients over 80 years old from the French Study Group for Large Vessel Vasculitis register who received TCZ were analyzed. Results Twenty-one GCA patients (median age 84 [81–90] years old, including nine over 85) received TCZ for the following nonexclusive reasons: glucocorticoid (GC)-sparing effect in 14, relapsing disease in 8, disease severity in 4, and/or failure of another immunosuppressant in 4. TCZ was introduced with GCs at diagnosis in 6 patients and at 8 [3–37] months after GC initiation in 15 others. After a median delay of 8 [2–21] months post-TCZ introduction, 14 (67%) patients were able to definitively stop GCs, including 6 who were GC-dependent before TCZ. At the last follow-up (median 20 [3–48] months), 11 (52%) patients had definitively stopped TCZ, and 2 additional patients had stopped but relapsed and resumed TCZ. Seven (33%) patients experienced 11 adverse events: hypercholesterolemia in 4 patients; infections, i.e., pyelonephritis, bronchitis, and fatal septic shock associated with mesenteric infarction following planned surgery (GCs were stopped for 1 year and TCZ infusions for 2 months), respectively, in 3 patients; moderate thrombocytopenia and moderate neutropenia in 2 patients; and a 5-fold increase in transaminase levels in another that improved after TCZ dose reduction. Conclusion TCZ remains a valuable GC-sparing option in the oldest GCA patients with an interesting risk-benefit ratio. Mild-to-moderate adverse events were observed in one-third of patients.

scholarly journals Comparison of idiopathic (isolated) aortitis and giant cell arteritis-related aortitis. A French retrospective multicenter study of 117 patients

2016 ◽  
Vol 15 (6) ◽  
pp. 571-576 ◽  
Author(s):  
Olivier Espitia ◽  
Maxime Samson ◽  
Thomas Le Gallou ◽  
Jérôme Connault ◽  
Cedric Landron ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Multicenter Study ◽  
Retrospective Multicenter Study

scholarly journals THU0439 Tocilizumab in giant cell arteritis. national multicenter study of 134 patients of clinical practice

2018 ◽  
Author(s):  
D. Prieto-Peña ◽  
J. Loricera ◽  
J. Martín-V ◽  
M. Calderón-G ◽  
V. Aldasoro ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Multicenter Study

scholarly journals Diagnostic value of ultrasound halo count and Halo Score in giant cell arteritis: a retrospective study from routine care

2020 ◽  
pp. annrheumdis-2020-218631 ◽  
Author(s):  
Juan Molina Collada ◽  
Julia Martínez-Barrio ◽  
Belén Serrano-Benavente ◽  
Isabel Castrejón ◽  
Liz Rocío Caballero Motta ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Diagnostic Value ◽  
Routine Care

scholarly journals 335. FLARE RATES IN GIANT CELL ARTERITIS: A SINGLE-CENTRE LONG-TERM RETROSPECTIVE STUDY

Rheumatology ◽  
2017 ◽  
Vol 56 (suppl_2) ◽  
Author(s):  
Faidra Laskou ◽  
Gouri Koduri ◽  
Elliott Lever ◽  
Philip Stapleton ◽  
Bhaskar Dasgupta
Keyword(s):  
Retrospective Study ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Single Centre

scholarly journals P188 Tocilizumab for giant cell arteritis: real world experience in a single UK centre

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Gary Reynolds ◽  
Bridget Griffiths ◽  
Karolyn Houghton ◽  
Ben Thompson ◽  
Alice R Lorenzi ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Adverse Events ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Urinary Tract Infections ◽  
Visual Loss ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Tract Infections ◽  
Clinical Records

Abstract Background Tocilizumab was approved for the treatment of giant cell arteritis (GCA) by NICE in April 2018. This decision followed the GiACTA (Giant Cell Arteritis Actemra) study, a randomised control trial that demonstrated a beneficial effect of tocilizumab in reducing the frequency of disease flare and overall prednisolone requirements. However, as noted in the NICE appraisal, the extent to which the patient population in the GiACTA study reflects the population it is eventually used for in UK clinical practice is not clear. To address this, we analysed the records of all patients started on tocilizumab treatment for GCA in a single centre since its approval. Methods We performed a retrospective analysis of the clinical records of all patients started on tocilizumab for GCA at the Freeman Hospital in Newcastle. All patients are discussed in a regional connective tissue disease MDT prior to the initiation of therapy to ensure they fulfil NICE guidelines. At each subsequent visit adverse events related to both tocilizumab and corticosteroids and any flares of GCA or ischaemic events are recorded. Results In total 14 patients started tocilizumab since June 2018, with a cumulative exposure of 8 patient-years. The mean age was 74 years, slightly older than the average age in the GiACTA trial (69 years). In contrast to GiACTA where 48% of patients were newly diagnosed, all our patients had established disease. In our cohort 36% of patients had CT PET evidence of large vessel vasculitis, similar to the rate in GiACTA (40%) but higher than the national average of around 5%. Incidence of visual loss in our treated patients was higher at 29% than recorded in the general GCA population in the DC-VAS study (7.9%). In those treated for relapsing disease around half (56%) had recorded previous significant adverse events with steroids, including heart failure, hypertension and mood changes. Five patients had infections requiring antibiotics (cellulitis/ulcer in three, chest infection in one, urinary tract infections in two), with two serious infections requiring hospital admission (both urinary tract infections). No patients had further ischaemic events while on treatment. All patients were on a lower dose of prednisolone following treatment with an average of a 63% reduction in steroid dose. Conclusion The modest number of patients receiving tocilizumab for GCA suggests we are not treating everyone at first relapse. The higher rates of large vessel vasculitis, visual loss and previous steroid-induced complications suggest a preference for saving tocilizumab for a more severely affected subset of patients. In this preliminary data there were reassuringly no recorded ischaemic events following treatment and steroid doses were successfully reduced in all patients. Disclosures G. Reynolds None. B. Griffiths None. K. Houghton None. B. Thompson None. A.R. Lorenzi None. J. Heaney None.

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