Poster Session A
Vasculitis
Carmen Lasa Teja, MD
Hospital Universitario Marqués de Valdecilla
Riotuerto, Spain
No financial relationships with ineligible companies to disclose
Tocilizumab (TCZ) seems to be effective in large vessel (LV) vasculitis including giant cell arteritis (GCA) and Takayasu arteritis (TAK). LV-GCA phenotype shares some features with TAK, but also shows differences that may influence the TCZ therapeutic response.
Methods:
A comparative observational multicenter study between LV-GCA (n=70) and TAK (n=57) patients treated with TCZ was conducted. Outcome variables were assessed at baseline, 1, 3, 6 and 12 months after TCZ and included: a) clinical remission and laboratory markers improvement; b) imaging improvement; c) GC-sparing effect; and d) safety analysis.
Results:
At TCZ initiation, TAK patients were younger, had longer disease duration, prior exposure to more biologics, and were on higher prednisone doses. Although an initial slower clinical clinical remission was observed in TAK patients, similar rates were observed at 12 months (74.5% and 76.9% of LV-GCA and TAK, respectively). A rapid improvement of laboratory markers and GC-sparing effect was observed in both groups. However, complete imaging improvement was only observed in 18.9% and 21.1% of LV-GCA and TAK patients. Safety data were similar in both groups. TCZ discontinuation due to severe infections occurred in 4 LV-GCA and three TAK patients.
Conclusion: In a real-world setting, TCZ showed comparable effectiveness in achieving remission and GC-sparing effects in LV-GCA and TAK. A discordance between clinical and imaging activity improvement was observed in both groups.
Table 1. Main clinical features of patients with refractory extracranial LV-GCA and TAK at TCZ initiation.
Figure 1. (A) Remission (clinical and analytic) and remission by imagen techniques at 12 months os follow-up. (B) Evolution of CRP (mg/dl) in patients with extracranial LV-GCA and TAK at 1, 3, 6 and 12 months after Tocilizumab initiation and C) prednisone doce (mg/day).
*p < 0.001 vs baseline values. Significant differences between both groups were expressed as +.
C. Lasa Teja: None; J. Loricera: AstraZeneca, 2, 6, Celgene, 2, 6, Eli Lilly, 5, Janssen, 5, Merck/MSD, 2, 5, 6, Novartis, 12, Formation/Congress attendance, Pfizer, 5, Roche, 2, 5, 6, UCB, 2, 5, 6; D. Prieto-Peña: None; f. lopez gutierrez: None; P. Bernabéu: None; M. Freire González: None; i. Ferraz-Amaro: AbbVie/Abbott, 5, 6, Celgene, 6, Janssen, 5, Merck/MSD, 5, 6, Pfizer, 6, Roche, 5, 6, sanofi, 6; S. Castañeda: Bristol-Myers Squibb(BMS), 2, 6, Eli Lilly, 2, 6, Merck/MSD, 2, 5, 6, Pfizer, 5, Roche, 2, 6, UCB, 2, 5; M. Mínguez: None; B. bravo-Mancheño: None; R. Solans-Laqué: CSL-Vifor, 2, 6, GlaxoSmithKlein(GSK), 2, 6, Menarini, 12, Support for attending meetings; R. Blanco-Alonso: AbbVie, 2, 5, 6, Bristol-Myers Squibb, 2, 6, Galapagos, 6, Janssen, 2, 6, Lilly, 2, 6, MSD, 2, 5, 6, Pfizer, 2, 6, Roche, 2, 5, 6.