Vasculitis & polymyalgia rheumatica
Relapse Risk and Safety of Long-Term Tocilizumab Use Among Patients With Giant Cell Arteritis: A Single-Enterprise Cohort Study
Authors' conclusion
TCZ is well tolerated in GCA, with low rates of discontinuation for AESIs. However, relapse occurred in > 50% despite median treatment > 12 months.
Study context
- Population
- Patients with giant cell arteritis (GCA) treated with tocilizumab (TCZ) between January 1, 2010, and May 15, 2020, large North American cohort60.5% female
- Participants
- 114 patients
- Exposure
- Annualized relapse rates before, during and after TCZ use
- Outcome
- Relapse rate (relapses/person-year)
Methodological detailssingle-enterprise, Kaplan-Meier, Poisson regression, age- and sex-adjusted Cox models
- Single-enterprise
- Kaplan-Meier
- Poisson regression
- Age- and sex-adjusted Cox models
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
Relapse after TCZ discontinuation
- Patients who stopped TCZ (after median 16.8 months)
- 52
- Relapsed after discontinuation
- 27
- Median time to relapse after discontinuation
- 8.4 months
- Relapsed within 12 months
- 58%
- Neither dose/route of TCZ, large-vessel vasculitis, nor duration of TCZ before discontinuation predicted relapse after TCZ stop
TCZ treatment duration
- Median overall duration of TCZ treatment
- 2.3 years
- Median duration from GCA diagnosis to TCZ start
- 4.5 months
Safety
Discontinuation of TCZ because of adverse events of significant interest (AESIs)
- Patients who stopped TCZ because of AESIs
- 14.9%
Original publication
Relapse Risk and Safety of Long-Term Tocilizumab Use Among Patients With Giant Cell Arteritis: A Single-Enterprise Cohort Study. J Rheumatol. Published 15 June 2023. doi:10.
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