Tocilizumab in Extracranial Giant-Cell Arteritis and Takayasu Arteritis: A Multicentric Observational Comparative Study

Tocilizumab (TCZ) has demonstrated potential efficacy in managing large-vessel (LV) vasculitis such as giant-cell arteritis (GCA) and Takayasu arteritis (TAK). Despite the shared characteristics between the LV-GCA phenotype and TAK, there are differences between both entities that may affect therape...

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Main Authors: Carmen Lasa-Teja, Javier Loricera, Diana Prieto-Peña, Fernando López-Gutiérrez, Pilar Bernabéu, María Mercedes Freire-González, Beatriz González-Alvarez, Roser Solans-Laqué, Mauricio Mínguez, Iván Ferraz-Amaro, Santos Castañeda, Ricardo Blanco, on behalf of the Tocilizumab in Large-Vessel Vasculitis Spanish Collaborative Group
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Sci
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Online Access:https://www.mdpi.com/2413-4155/7/1/12
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author Carmen Lasa-Teja
Javier Loricera
Diana Prieto-Peña
Fernando López-Gutiérrez
Pilar Bernabéu
María Mercedes Freire-González
Beatriz González-Alvarez
Roser Solans-Laqué
Mauricio Mínguez
Iván Ferraz-Amaro
Santos Castañeda
Ricardo Blanco
on behalf of the Tocilizumab in Large-Vessel Vasculitis Spanish Collaborative Group
author_facet Carmen Lasa-Teja
Javier Loricera
Diana Prieto-Peña
Fernando López-Gutiérrez
Pilar Bernabéu
María Mercedes Freire-González
Beatriz González-Alvarez
Roser Solans-Laqué
Mauricio Mínguez
Iván Ferraz-Amaro
Santos Castañeda
Ricardo Blanco
on behalf of the Tocilizumab in Large-Vessel Vasculitis Spanish Collaborative Group
author_sort Carmen Lasa-Teja
collection DOAJ
description Tocilizumab (TCZ) has demonstrated potential efficacy in managing large-vessel (LV) vasculitis such as giant-cell arteritis (GCA) and Takayasu arteritis (TAK). Despite the shared characteristics between the LV-GCA phenotype and TAK, there are differences between both entities that may affect therapeutic responses to TCZ. We aim to assess and compare the effectiveness and safety of TCZ in patients with LV-GCA and TAK. Multicenter, observational study on 70 LV-GCA patients and 57 TAK patients treated with TCZ. Outcomes were assessed at baseline and at 1, 3, 6 and 12 months post-treatment initiation. The variables analyzed included the following: (a) the achievement of clinical remission and improvement in laboratory markers; (b) imaging-based disease activity; (c) a glucocorticoid (GC)-sparing effect; and (d) side events and a safety profile. At the treatment initiation, TAK patients were younger, exhibited longer disease duration, had received more prior biologics, and were on higher doses of prednisone compared to LV-GCA patients. While TAK patients showed a slower initial clinical response, remission rates at 12 months were comparable between groups (74.5% for LV-GCA vs. 76.9% for TAK). Both groups experienced rapid laboratory marker improvement and a significant GC-sparing effect. However, complete imaging resolution was observed in only 18.9% of LV-GCA patients and 21.1% of TAK patients. The safety profile was similar in both groups, with severe infections leading to TCZ discontinuation in four LV-GCA and three TAK patients. In clinical practice, TCZ demonstrates similar efficacy in promoting remission and reducing GC dependency in both LV-GCA and TAK patients. Nonetheless, discrepancies between clinical outcomes and imaging improvement highlight the need for further investigation into disease monitoring and management strategies.
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spelling doaj-art-5b17fc91ddb54df3b9411ee3cfb8fbd92025-08-20T02:43:06ZengMDPI AGSci2413-41552025-01-01711210.3390/sci7010012Tocilizumab in Extracranial Giant-Cell Arteritis and Takayasu Arteritis: A Multicentric Observational Comparative StudyCarmen Lasa-Teja0Javier Loricera1Diana Prieto-Peña2Fernando López-Gutiérrez3Pilar Bernabéu4María Mercedes Freire-González5Beatriz González-Alvarez6Roser Solans-Laqué7Mauricio Mínguez8Iván Ferraz-Amaro9Santos Castañeda10Ricardo Blanco11on behalf of the Tocilizumab in Large-Vessel Vasculitis Spanish Collaborative GroupDepartment of Rheumatology, Hospital Universitario Marqués de Valdecilla, Immunopathology Group, IDIVAL, Avenida Valdecilla s/n, 39008 Santander, SpainDepartment of Rheumatology, Hospital Universitario Marqués de Valdecilla, Immunopathology Group, IDIVAL, Avenida Valdecilla s/n, 39008 Santander, SpainDepartment of Rheumatology, Hospital Universitario Marqués de Valdecilla, Immunopathology Group, IDIVAL, Avenida Valdecilla s/n, 39008 Santander, SpainDepartamento de Reumatología, Hospital Universitario Ramón y Cajal, 28034 Madrid, SpainDepartment of Rheumatology, Hospital General de Alicante, 03010 Alicante, SpainDepartment of Rheumatology, Complejo Hospital Universitario de A Coruña, 15006 A Coruña, SpainDepartment of Rheumatology, Hospital Nuestra Señora de la Candelaria, 38010 Tenerife, SpainInternal Medicine, Hospital Vall d’Hebron, 08035 Barcelona, SpainDepartment of Rheumatology, Hospital San Juan de Alicante, 03550 Alicante, SpainDepartment of Rheumatology, Hospital Universitario de Canarias, 38320 La Laguna, SpainDepartment of Rheumatology, Hospital Universitario de La Princesa, IIS-Princesa, 28006 Madrid, SpainDepartment of Rheumatology, Hospital Universitario Marqués de Valdecilla, Immunopathology Group, IDIVAL, Avenida Valdecilla s/n, 39008 Santander, SpainTocilizumab (TCZ) has demonstrated potential efficacy in managing large-vessel (LV) vasculitis such as giant-cell arteritis (GCA) and Takayasu arteritis (TAK). Despite the shared characteristics between the LV-GCA phenotype and TAK, there are differences between both entities that may affect therapeutic responses to TCZ. We aim to assess and compare the effectiveness and safety of TCZ in patients with LV-GCA and TAK. Multicenter, observational study on 70 LV-GCA patients and 57 TAK patients treated with TCZ. Outcomes were assessed at baseline and at 1, 3, 6 and 12 months post-treatment initiation. The variables analyzed included the following: (a) the achievement of clinical remission and improvement in laboratory markers; (b) imaging-based disease activity; (c) a glucocorticoid (GC)-sparing effect; and (d) side events and a safety profile. At the treatment initiation, TAK patients were younger, exhibited longer disease duration, had received more prior biologics, and were on higher doses of prednisone compared to LV-GCA patients. While TAK patients showed a slower initial clinical response, remission rates at 12 months were comparable between groups (74.5% for LV-GCA vs. 76.9% for TAK). Both groups experienced rapid laboratory marker improvement and a significant GC-sparing effect. However, complete imaging resolution was observed in only 18.9% of LV-GCA patients and 21.1% of TAK patients. The safety profile was similar in both groups, with severe infections leading to TCZ discontinuation in four LV-GCA and three TAK patients. In clinical practice, TCZ demonstrates similar efficacy in promoting remission and reducing GC dependency in both LV-GCA and TAK patients. Nonetheless, discrepancies between clinical outcomes and imaging improvement highlight the need for further investigation into disease monitoring and management strategies.https://www.mdpi.com/2413-4155/7/1/12tocilizumabTakayasu’s arteritisgiant-cell arteritislarge-vessel vasculitis
spellingShingle Carmen Lasa-Teja
Javier Loricera
Diana Prieto-Peña
Fernando López-Gutiérrez
Pilar Bernabéu
María Mercedes Freire-González
Beatriz González-Alvarez
Roser Solans-Laqué
Mauricio Mínguez
Iván Ferraz-Amaro
Santos Castañeda
Ricardo Blanco
on behalf of the Tocilizumab in Large-Vessel Vasculitis Spanish Collaborative Group
Tocilizumab in Extracranial Giant-Cell Arteritis and Takayasu Arteritis: A Multicentric Observational Comparative Study
Sci
tocilizumab
Takayasu’s arteritis
giant-cell arteritis
large-vessel vasculitis
title Tocilizumab in Extracranial Giant-Cell Arteritis and Takayasu Arteritis: A Multicentric Observational Comparative Study
title_full Tocilizumab in Extracranial Giant-Cell Arteritis and Takayasu Arteritis: A Multicentric Observational Comparative Study
title_fullStr Tocilizumab in Extracranial Giant-Cell Arteritis and Takayasu Arteritis: A Multicentric Observational Comparative Study
title_full_unstemmed Tocilizumab in Extracranial Giant-Cell Arteritis and Takayasu Arteritis: A Multicentric Observational Comparative Study
title_short Tocilizumab in Extracranial Giant-Cell Arteritis and Takayasu Arteritis: A Multicentric Observational Comparative Study
title_sort tocilizumab in extracranial giant cell arteritis and takayasu arteritis a multicentric observational comparative study
topic tocilizumab
Takayasu’s arteritis
giant-cell arteritis
large-vessel vasculitis
url https://www.mdpi.com/2413-4155/7/1/12
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