Tocilizumab monotherapy versus combined in aortitis associated with giant cell arteritis: Factors associated with imaging remission in a multicenter open-label study of 196 patients

Martín-Gutiérrez, A; Loricera, J; Prieto-Peña, D; Aldasoro, V; Maiz, O; de Miguel, E; Galíndez-Agirregoikoa, E; Ferraz-Amaro, I; Castañeda, S; Blanco, R; Tocilizumab in Giant Cell Arteritis Spanish Collaborative Group

doi:10.1016/j.semarthrit.2025.152869

Tocilizumab monotherapy versus combined in aortitis associated with giant cell arteritis: Factors associated with imaging remission in a multicenter open-label study of 196 patients

Semin Arthritis RheumPublished 6 Nov 2025Multicentre observational study

Main finding · Imaging remissionResultOR for imaging remission (multivariable logistic regression) 5.26 95% CI 1.03–26.85

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Authors' conclusion

In patients with GCA-aortitis, TCZcombo may be more effective than TCZmono in achieving imaging remission and promoting glucocorticoid tapering, but without definitive evidence regarding a reduction of serious adverse events.

Study context

Population: Patients with giant cell arteritis (GCA)-aortitis treated with tocilizumab (TCZ) in real-world practice148 female, 48 male
Participants: 196 patients

Exposure: TCZ plus conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) vs TCZ monotherapy
TCZcombon = 60
TCZ monotherapy (TCZmono)n = 136reference
Outcome: Imaging remission
Follow-up: 24 months

Methodological detailsopen-label, real-world practice, multivariable logistic regression

Open-label
Real-world practice
Multivariable logistic regression

Main finding

As reported in the abstract

OR for imaging remission (multivariable logistic regression)

5.26

95% CI 1.03–26.85

P = 0.046

By group

TCZcombo50.0%

TCZmono15.8%

TCZcombovs TCZmono

OR for imaging remission (multivariable logistic regression) 5.26 (95% CI 1.03–26.85); P = 0.046

Observational data: associations, not effects.

Further findings

Clinical and EULAR-defined remission

No significant differences

Prednisone-sparing effect

TCZcombo demonstrated a prednisone-sparing effect

Safety

SAE rate · numerically lower with TCZcombo

P = 0.21

TCZcombo8.7 per 100 patient-years

TCZmono13.2 per 100 patient-years

Original publication

Tocilizumab monotherapy versus combined in aortitis associated with giant cell arteritis: Factors associated with imaging remission in a multicenter open-label study of 196 patients. Semin Arthritis Rheum. Published 6 November 2025. doi:10.1016/j.semarthrit.2025.152869

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