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 Detalle_Publicacion

Tocilizumab in refractory giant cell arteritis. Monotherapy versus combined therapy with conventional immunosuppressive drugs. Observational multicenter study of 134 patients

Abstract: Objective: To compare the efficacy and safety of TCZ in monotherapy (TCZMONO) vs. combined with conventional immunosuppressive drugs (TCZCOMBO) in Giant Cell Arteritis (GCA) in a clinical practice scenario. Methods: Multicenter study of 134 patients with refractory GCA. Patients on TCZMONO (n = 82) were compared with those on TCZCOMBO (n = 52). Drugs were methotrexate (MTX) (n = 48), azathioprine (n = 3), and leflunomide (n = 1). The main outcomes were: prolonged remission (normalization of clinical and laboratory parameters for at least 6 months) and the number of relapses. Results: Patients on TCZCOMBO were younger (68.8 ± 8.0 vs 71.2 ± 9.0 years; p = 0.04), with a trend to a longer GCA duration (median [IQR],18.5 [6.25-34.0] vs. 13.0 [7.75-33.5] months; p = 0.333), higher C-reactive protein (CRP) levels (2.1[1-4.7] vs 1.2 [0.2-2.4] mg/dL; p = 0.003), and more prevalence of extra-cranial large-vessel vasculitis (LVV) (57% vs. 34.1%; p = 0.007). In both groups, rapid and sustained improvement was observed. Despite the longer GCA duration, and the higher CRP levels and prevalence of LVV in the TCZCOMBO, the improvement was similar in both groups at 12 months. Moreover, in the TCZCOMBO group, prolonged remission was significantly higher at 12-month. Relapses and serious adverse events were similar in both groups. Conclusion: In clinical practice, TCZ in monotherapy or combined with conventional immunosuppressive agents is effective and safe in patients with GCA. Nevertheless, the addition of immunosuppressive drugs, usually MTX, seems to allow a higher rate of prolonged remission, even in patients with a longer GCA duration, more extra-cranial LVV involvement, and higher acute-phase reactants.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: Semin Arthritis Rheum . 2021 Apr;51(2):387-394

Editorial: Elsevier

 Año de publicación: 2021

Nº de páginas: 8

Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.semarthrit.2021.01.006

ISSN: 0049-0172,1532-866X

Url de la publicación: https://doi.org/10.1016/j.semarthrit.2021.01.006

Autores/as

CALDERÓN-GOERCKE, MÓNICA

CASTAÑEDA, SANTOS

ALDASORO, VICENTE

VILLA, IGNACIO

MORIANO, CLARA

ROMERO-YUSTE, SUSANA

NARVÁEZ, JAVIER

GÓMEZ-ARANGO, CATALINA

PÉREZ-PAMPÍN, EVA

MELERO, RAFAEL

BECERRA-FERNÁNDEZ, ELENA

REVENGA, MARCELINO

ÁLVAREZ-RIVAS, NOELIA

GALISTEO, CARLES

SIVERA, FRANCISCA

DE MIGUEL, EUGENIO

RICARDO BLANCO ALONSO

TOCILIZUMAB IN GIANT CELL ARTERITIS SPANISH COLLABORATIVE GROUP