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

Abstract

Background Giant cell arteritis (GCA) can be refractory to corticosteroids1–3. 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 42–9 mm/1st hour and c) Prednisone dose from 1510–30 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.![][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 [1]: /embed/graphic-1.gif