Artikel
Rate of relapse in giant cell arteritis patients after tocilizumab therapy was stopped – the Munich GCA patient cohort
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Autoren
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Antoine Murray
- Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München
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Friederike Lutz
- Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München
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Alla Skapenko
- Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München
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Hendrick Schulze-Koops
- Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München
| Veröffentlicht: | 9. September 2020 |
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Gliederung
Text
Introduction: 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.
Our objective is to assess if there is any association between disease duration before starting TCZ and/or TCZ duration before stopping with the rate of relapse of the Munich GCA patient cohort after TCZ treatment was stopped due to either remission or secondary adverse events (SAEs - excluding relapse on TCZ as a SAE) in a real-life setting.
Methods: A retrospective observation of patients with GCA treated with TCZ in our department between 2012-2020. 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, duration of therapy before stopping and time to relapse of the disease. 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 interim study included 38 GCA patients (mean age 74,8, 74% females). The median duration of disease before TCZ was initiated was 4 months (range 0 – 84). TCZ was stopped in 15 patients due to either remission or SAEs of which 9 went on to suffer a relapse. The median duration of TCZ before stopping in patients who did not go on to suffer relapse was 12,5 months (range 1 – 55) and who did go on to suffer relapse was 12 months (range 6 – 78). The mean time to relapse after discontinuing TCZ was 10,11 ± 6,43 months.
Conclusion: Our retrospective observational interim analysis suggests that there is a high chance of relapse in GCA patients after stopping TCZ and this is independent of time from disease onset to initiation of TCZ therapy and independent of duration of prior TCZ therapy.
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Disclosures: The Authors have declared no conflicts of interest.
References
- 1.
- Stone JH, et al. Trial of Tocilizumab in Giant-Cell Arteritis. N Engl J Med. 2017;377(15):1494-5.
