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POS0802 (2022)
INVOLVEMENT OF THE AORTA AND/OR ITS MAIN BRANCHES IN GIANT CELL ARTERITIS. TREATMENT WITH TOCILIZUMAB
L. Sanchez-Bilbao1, J. Loricera1, R. Melero2, S. Castañeda3, C. Moriano4, I. Ferraz-Amaro5, J. Narváez6, V. Aldasoro7, O. Maiz8, I. Villa-Blanco9, P. Vela-Casasempere10, S. Romero-Yuste11, J. L. Callejas-Rubio12, E. De Miguel13, E. Galíndez-Agirregoikoa14, F. Sivera15, C. Fernández-López16, C. Galisteo17, J. Sanchez-Martin1, M. Calderón-Goercke1, J. L. Hernández18, M. A. González-Gay1, R. Blanco1, on behalf of On behalf on Tocilizumab in Giant Cell Arteritis Spanish Collaborative Group.
1H.U. Marqués de Valdecilla, Rheumatology, Santander, Spain
2Complexo Hospitalario Universitario de Vigo, Rheumatology, Vigo, Spain
3Hospital Universitario de La Princesa, Rheumatology, Madrid, Spain
4Complejo Asistencial Universitario de León, Rheumatology, León, Spain
5Complejo Hospitalario Universitario de Canarias, Rheumatology, Tenerife, Spain
6Hospital de Bellvitge, Rheumatology, Barcelona, Spain
7Complejo Hospitalario de Navarra, Rheumatology, Pamplona, Spain
8Hospital Universitario de Donosti, Rheumatology, San Sebastián, Spain
9H.Sierrallana, Rheumatology, Torrelavega, Spain
10Hospital General Universitario de Alicante, Rheumatology, Santander, Spain
11Complejo Hospitalario Universitario de Pontevedra, Rheumatology, Pontevedra, Spain
12Hospital San Cecilio, Rheumatology, Granada, Spain
13Hospital La Paz, Rheumatology, Madrid, Spain
14Hospital de Basurto, Rheumatology, Bilbao, Spain
15Hospital Universitario de Elda, Rheumatology, Elda, Spain
16Hospital Universitario Juan Canalejo, Rheumatology, A Coruña, Spain
17Hospital Parc Taulí, Rheumatology, Barcelona, Spain
18H.U. Marqués de Valdecilla, Internal Medicine, Santander, Spain

Background: Large vessel involvement in Giant Cell Arteritis (GCA), especially the aorta and/or its main branches, is frequent. Tocilizumab (TCZ) has shown efficacy and safety in GCA and other large-vessel vasculitis (1-4 ).


Objectives: To assess the efficacy and safety of TCZ in GCA patients with involvement of the aorta and/or its main branches.


Methods: Multicenter observational study of 196 patients with GCA and involvement of the aorta and/or its major branches treated with TCZ. GCA was diagnosed by: a ) ACR criteria, and/or b ) temporal artery biopsy, and/or c ) imaging techniques. The presence of aortitis was performed by imaging techniques, mainly PET, and A-MRI.

Maintained remission was considered according to EULAR definitions (5 ).


Results: The main features of the 196 patients are showed in Table 1 . Polymyalgia rheumatica, constitutional syndrome and headache were the most frequent clinical manifestations at TCZ onset. At 6 months after starting TCZ, 20% of the patients reached a sustained remission, that was progressively increasing. ( Figure 1 ). A corticosteroid-sparing effect was observed from month 1 of TCZ onset ( Figure 1 ). Relevant adverse events were observed in 12 per 100 patients-year, documenting serious infections in 4.8 per 100 patients-year ( Table 1 ).

Main features of 196 GCA patients with involvement of the aorta and/or its main branches treated with TCZ.

GCA (n=196 )
Features at TCZ onset
Age(years), mean±SD 71.3±9.5
Sex, female/male (% female) 148/48 (75)
Time from GCA diagnosis to TCZ onset (months), median [IQR] 7 [2-18.25]
Systemic manifestations, n (% )
Fever, n (%) 24 (12)
Constitutional syndrome, n (%) 87 (44)
PmR, n (%) 131 (67)
Ischaemic manifestations, n (% )
Visual involvement, n (%) 16 (8)
Headache, n (%) 74 (38)
Jaw claudication, n (%) 27 (14)
Laboratory data
ESR, mm 1st hour, median [IQR] 32 [14-54]
CRP, mg/dL, median [IQR] 1.5 [0.6-3.2]
Prednisone dose, mg/day, median [IQR] 15 [10-30]
Safety after TCZ onset
Relevant adverse events, per 100 patients-year 12
Serious infections, per 100 patients-year 4.8

A ) Sustained remission, and B ) median prednisone dose required in GCA patients with aortitis treated with tocilizumab


Conclusion: TCZ seems to be effective and relatively safe in GCA patients with involvement of the aorta and/or its main branches.


REFERENCES:

[1]Calderón-Goercke M, et al. Semin Arthritis Rheum. 2019; 49: 126-135. PMID: 30655091

[2]Loricera J, et al. Clin Exp Rheumatol. 2016; 34: S44-53. PMID: 27050507

[ 3]Loricera J, et al. Clin Exp Rheumatol. 2015; 33: S19-31. PMID: 25437450

[4]Prieto-Peña D, et al. Ther Adv Musculoskelet Dis. 2021; 13: 1759720X211020917. PMID: 34211589

[5]Hellmich B, et al. Ann Rheum Dis. 2020; 79: 19-30. PMID: 31270110


Disclosure of Interests: Lara Sanchez-Bilbao: None declared, Javier Loricera Speakers bureau: from Roche, Novartis, UCB Pharma, Celgene, and Grünenthal., Rafael Melero: None declared, Santos Castañeda Speakers bureau: UAM-Roche, EPID- Future chair, Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain., Clara Moriano: None declared, Iván Ferraz-Amaro: None declared, J. Narváez: None declared, Vicente Aldasoro: None declared, Olga Maiz: None declared, Ignacio Villa-Blanco: None declared, Paloma Vela-Casasempere: None declared, Susana Romero-Yuste: None declared, Jose Luis Callejas-Rubio: None declared, Eugenio de Miguel: None declared, E. Galíndez-Agirregoikoa: None declared, Francisca Sivera: None declared, Carlos Fernández-López: None declared, Carles Galisteo: None declared, Julio Sanchez-Martin: None declared, Monica Calderón-Goercke: None declared, J. Luis Hernández: None declared, Miguel A González-Gay Speakers bureau: Abbvie, Pfizer, Roche, Sanofi, Lilly, Celgene, and MSD., Grant/research support from: AbbVie, MSD, Jansen, and Roche,, Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Lilly, Janssen, and MSD., Grant/research support from: Abbvie, MSD, and Roche

Citation: , volume 81, supplement 1, year 2022, page 689
Session: Vasculitis – large vessel vasculitis (POSTERS only)