Vasculitis & polymyalgia rheumatica
Does tocilizumab eliminate inflammation in giant cell arteritis (GCA)? A cohort study on repeated temporal artery biopsies
Authors' conclusion
Our study, using pathological and imaging assessments, revealed that after TCZ and GCs, over one-third of patients still presented with vascular inflammation.
Study context
- Population
- Consecutive GCA patients with an inflamed temporal artery biopsy (TAB) at diagnosis treated with tocilizumab (TCZ) and glucocorticoid (GCs) for ≥6 months, followed December 2017 to December 2023median TCZ 2.4 years (Q1-Q3: 1.2–3.9)
- Participants
- 13 patients
- Exposure
- Repeated TAB, PET/CT and colour Doppler ultrasonography (CDUS) after TCZ plus GCs vs pretreatment findings
- Outcome
- Histological inflammation on repeated TAB
Methodological detailsconsecutive patients, repeated temporal artery biopsies
- Consecutive patients
- Repeated temporal artery biopsies
Main finding
As reported in the abstract
Some degree of inflammation on repeated TAB
- Patients still showing some inflammation on repeated TAB
- 5 (38.5%)
- Among 11 with initial transmural inflammation (TMI), at second TAB: Inflammation limited to adventitia (ILA)
- 2
- Among 11 with initial TMI, at second TAB: TMI
- 1
- Among 11 with initial TMI, at second TAB: Small vessel vasculitis (SVV)
- 1
- Among 11 with initial TMI, at second TAB: vasa vasorum vasculitis
- 1
Observational data: associations, not effects.
Further findings
| Outcome | Mean PET vascular activity score reduction (95% CI) | P value |
|---|---|---|
| PET/CT vascular activity · last PET/CTLast PET/CT vs Baseline PET/CT | −6.5 (1.54–11.45) | P = 0.017 |
- PET/CT vascular activity — Active vasculitis at baseline PET/CT
- 9
- PET/CT vascular activity — Still active at last PET/CT
- 3 (33.3%)
First TAB histology · diagnosis
- TMI
- 11/13 (84.6%)
- ILA
- 1 (7.7%)
- SVV
- 1 (7.7%)
Repeated quantitative CDUS of temporal arteries
- Altered parameters suggestive of vasculitis in about one-third of patients
Original publication
Does tocilizumab eliminate inflammation in GCA? A cohort study on repeated temporal artery biopsies. RMD Open. Published 31 December 2024. doi:10.
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