gms | German Medical Science

Background: Tocilizumab (TCZ) subcutaneously (SC) administered has been licensed in Germany since 2017 following the results of the GiACTA study for the treatment of giant cell arteritis (GCA) and thus is an alternative therapy option to long-term glucocorticoids (GC) and other immunosuppressive treatments.

Objective: To describe the clinical findings of the Munich GCA patient cohort treated with TCZ in a real-life setting.

Methods: A retrospective observation of patients with GCA treated with TCZ in our department between 2012-2018. The diagnosis of GCA was made clinically supported by PET, Ultrasound or temporal artery biopsy. TCZ was given either intravenously (IV) or subcutaneously. We assessed duration of disease before starting TCZ, number of relapses either under TCZ or after therapy was stopped, time to relapse of the disease, and GC use at initiation of TCZ as well as 6 and 12 Months after starting the therapy. Relapse of disease was defined as a recurrence of GCA clinical manifestations, increase of inflammatory markers and/or evidence of vasculitis in imaging.

Results: The retrospective study included 30 GCA patients (mean age 72,0, 73% females). The mean duration of disease before TCZ was initiated was 16,2 ± 19,97 months. 13,3% of the patients were treated 1st line with TCZ once the diagnosis of GCA was made. The median dose of GC at TCZ initiation was 20 [0-1000] mg, at 6 months 6 [0-20] mg and at 12 months 4,5 [0-7,5] mg after starting TCZ. 16,7% patients had a relapse under TCZ. Of the 23% patients who had a relapse after discontinuing TCZ, all of them were previously treated with TCZ IV but none with TCZ SC. The mean time to relapse after discontinuing TCZ was 9,5 ± 4,46 months.

Conclusion: Our retrospective observational analysis supports the findings in the GiACTA study that treating TCZ is an effective steroid-sparing therapy in treating GCA.