Vision loss in patients with giant cell arteritis treated with tocilizumab.

Amsler, Jennifer; Kysela, Iveta; Tappeiner, Christoph; Seitz, Luca; Christ, Lisa; Scholz, Godehard; Stalder, Odile; Kollert, Florian; Reichenbach, Stephan; Villiger, Peter (2021). Vision loss in patients with giant cell arteritis treated with tocilizumab. Arthritis research & therapy, 23(1), p. 92. BioMed Central 10.1186/s13075-021-02480-4

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OBJECTIVES

Giant cell arteritis (GCA) may lead to vision loss. To what extent tocilizumab (TCZ) is able to prevent vision loss is unknown. The aim was to analyze the occurrence of vision loss in a large GCA cohort treated with TCZ.

METHODS

In this observational monocentric study, GCA patients treated with TCZ between the years 2010 and 2018 were studied. Demographic, clinical, and laboratory data were analyzed.

RESULTS

A total of 186 patients were included (62% female); 109 (59%) fulfilled the American College of Rheumatology (ACR) criteria, in 123 (66%) patients, large vessel vasculitis was diagnosed by magnetic resonance-angiography (MRA). Cumulative duration of TCZ treatment was 224 years, median treatment duration was 11.1 (IQR 5.6-17.9) months. Glucocorticoids (GC) were tapered over a median of 5.8 (IQR 3.0-8.5) months. At baseline, visual symptoms were present in 70 (38%) and vision loss in 21 (11%) patients. Patients with vision loss at baseline were older (p = 0.032), had a lower C-reactive protein (p = 0.002), and showed a negative association with MRA of the aorta (p = 0.006). Two patients (1.1%) developed vision loss, both at the initiation of TCZ treatment.

CONCLUSION

Our data show a very low incidence of vision loss in TCZ-treated patient. The two cases of AION occurred at the initiation of therapy, they support the hypothesis that advanced, and established structural changes of arteries are key factors for this accident. Whether a shorter duration of concomitant GC treatment is risky regarding vision loss needs to be studied.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Amsler, Jennifer Susann; Kyselá, Iveta; Tappeiner, Christoph; Seitz, Luca; Christ, Lisa Alexandra; Scholz, Godehard Albert; Stalder, Odile; Kollert, Florian Kim; Reichenbach, Stephan and Villiger, Peter

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1478-6354

Publisher:

BioMed Central

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

30 Mar 2021 19:17

Last Modified:

30 Mar 2021 19:17

Publisher DOI:

10.1186/s13075-021-02480-4

PubMed ID:

33752737

Uncontrolled Keywords:

Anterior ischemic optic neuropathy (AION) Giant cell arteritis Glucocorticoids Tocilizumab Vision loss

BORIS DOI:

10.48350/155061

URI:

https://boris.unibe.ch/id/eprint/155061

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