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Tocilizumab in giant cell arteritis. Observational, open-label multicenter study of 134 patients in clinical practice.

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2019-01-05

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Calderón-Goercke, Mónica
Loricera, Javier
Aldasoro, Vicente
Castañeda, Santos
Villa, Ignacio
Humbría, Alicia
Moriano, Clara
Romero-Yuste, Susana
Narváez, Javier
Gómez-Arango, Catalina

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Abstract

Tocilizumab (TCZ) has shown efficacy in clinical trials on giant cell arteritis (GCA). Real-world data are scarce. Our objective was to assess efficacy and safety of TCZ in unselected patients with GCA in clinical practice Methods: Observational, open-label multicenter study from 40 national referral centers of GCA patients treated with TCZ due to inefficacy or adverse events of previous therapy. Outcomes variables were improvement of clinical features, acute phase reactants, glucocorticoid-sparing effect, prolonged remission and relapses. A comparative study was performed: (a) TCZ route (SC vs. IV); (b) GCA duration (≤6 vs. >6 months); (c) serious infections (with or without); (d) ≤15 vs. >15 mg/day at TCZ onset. 134 patients; mean age, 73.0 ± 8.8 years. TCZ was started after a median [IQR] time from GCA diagnosis of 13.5 [5.0-33.5] months. Ninety-eight (73.1%) patients had received immunosuppressive agents. After 1 month of TCZ 93.9% experienced clinical improvement. Reduction of CRP from 1.7 [0.4-3.2] to 0.11 [0.05-0.5] mg/dL (p  In clinical practice, TCZ yields a rapid and maintained improvement of refractory GCA. Serious infections appear to be higher than in clinical trials.

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Aged
Aged, 80 and over
Antibodies, Monoclonal, Humanized
Female
Giant Cell Arteritis
Humans
Immunosuppressive Agents
Male
Middle Aged
Treatment Outcome

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Keywords

Biological therapy, Giant cell arteritis, Large-vessel vasculitis, Tocilizumab

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