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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Tocilizumab in giant cell arteritis: Multicenter open-label study of 22 patients
Seminars in Arthritis and Rheumatism, Volume 44, No. 6, Year 2015
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Description
Objective: To assess the efficacy of tocilizumab (TCZ) in giant cell arteritis (GCA) patients with refractory disease and/or with unacceptable side effects due to corticosteroids. Methods: A retrospective multicenter open-label study on 22 GCA patients treated with TCZ at standard dose of 8. mg/kg/month. The main outcomes were achievement of disease remission and reduction of corticosteroid dose. Results: The mean age ± standard deviation of patients was 69 ± 8 years. The main clinical features at TCZ onset were polymyalgia rheumatica (n = 16), asthenia (n = 7), headache (n =5), constitutional symptoms (n = 4), jaw claudication (n = 2), and visual loss (n = 2). Besides corticosteroids and before TCZ onset, 19 of 22 patients had also received several conventional immunosuppressive and/or biologic drugs. Of 22 patients, 19 achieved rapid and maintained clinical improvement following TCZ therapy. Also, after a median follow-up of 9 (interquartile range: 6-19) months, the C-reactive protein level had fallen from 1.9 (1.2-5.4) to 0.2 (0.1-0.9). mg/dL (p < 0.0001) and the erythrocyte sedimentation rate decreased from 44 (20-81) to 12 (2-20). mm/1st hour (p = 0.001). The median dose of prednisone was also tapered from 18.75 (10-45) to 5 (2.5-10). mg/day (p < 0.0001). However, TCZ had to be discontinued in 3 patients due to severe neutropenia, recurrent pneumonia, and cytomegalovirus infection. Moreover, 1 patient died after the second infusion of TCZ due to a stroke in the setting of an infectious endocarditis. Conclusion: TCZ therapy leads to rapid and maintained improvement in patients with refractory GCA and/or with unacceptable side effects related to corticosteroids. However, the risk of infection should be kept in mind when using this drug in patients with GCA. © 2015 Elsevier Inc..
Authors & Co-Authors
Loricera, Javier
Spain, Santander
Universidad de Cantabria
Blanco-Alonso, Ricardo
Spain, Santander
Universidad de Cantabria
Herńandez, José L.
Spain, Santander
Universidad de Cantabria
Castañeda, Santos
Spain, Madrid
Hospital Universitario de la Princesa
Mera-Varela, Antonio
Spain, Santiago de Compostela
Complejo Hospitalario Universitario de Santiago
Calvo-Alén, Jaime
Spain, Torrelavega
Hospital Sierrallana
Aurrecoechea, Elena
Spain, Torrelavega
Hospital Sierrallana
Díez, Elvira
Spain, Leon
Complejo Asistencial Universitario de León
Mata, Cristina
Spain, Laredo
Hospital de Laredo
Calvo-Río, Vanesa
Spain, Santander
Universidad de Cantabria
González-Vela, María Carmen
Spain, Santander
Universidad de Cantabria
Piña, Trinitario
Spain, Santander
Universidad de Cantabria
González-Gay, Miguel Ángel
Spain, Santander
Universidad de Cantabria
Statistics
Citations: 115
Authors: 13
Affiliations: 11
Identifiers
Doi:
10.1016/j.semarthrit.2014.12.005
ISSN:
00490172
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Cohort Study