Seitz, Luca; Christ, Lisa; Lötscher, Fabian; Scholz, Godehard; Sarbu, Adela-Cristina; Bütikofer, Lukas; Kollert, Florian; Schmidt, Wolfgang A; Reichenbach, Stephan; Villiger, Peter M. (2021). Quantitative ultrasound to monitor the vascular response to tocilizumab in giant cell arteritis. Rheumatology, 60(11), pp. 5052-5059. Oxford University Press 10.1093/rheumatology/keab484
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OBJECTIVES
To characterize the effect of ultra-short glucocorticoids followed by Tocilizumab monotherapy on the intima-media thickness (IMT) in GCA.
METHODS
18 GCA patients received 500mg methylprednisolone intravenously on days 0-2, followed by Tocilizumab (8mg/kg) intravenously on day 3 and thereafter weekly subcutaneous Tocilizumab injections (162 mg) over 52 weeks. Ultrasound of temporal (TA), axillary (AA) and subclavian (SA) arteries was performed at baseline, on days 2-3, at week 4, 8, 12, 24 and 52. The largest IMT of all segments and IMT at landmarks of AA/SA were recorded. IMT was scaled by mean normal values and averaged. Each segment was classified according to diagnostic cut-offs.
RESULTS
16 patients had TA and 6 had extracranial large artery involvement. The IMT showed a sharp decline on day 2/3 in the TA and AA/SA. In TA, this was followed by an increase to baseline levels at week 4 and a subsequent slow decrease, which was paralleled by decreasing symptoms and achievement of clinical remission. The AA/SA showed a new signal of vasculitis at week 4 in three patients with an IMT increase up to week 8.
CONCLUSIONS
Glucocorticoid pulse therapy induced a transient decrease of the IMT in TA and AA/SA. Tocilizumab monotherapy resulted in a slow and steady decrease in IMT of the TA and a smaller and delayed effect on the AA/SA. The data strongly support a remission-inducing effect of Tocilizumab and argue for an important role of ultrasound in monitoring disease activity in GCA.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology 04 Faculty of Medicine > Pre-clinic Human Medicine > Department of Clinical Research (DCR) |
UniBE Contributor: |
Seitz, Luca Fabio, Christ, Lisa Alexandra, Lötscher, Fabian, Scholz, Godehard Albert, Sarbu, Adela-Cristina, Bütikofer, Lukas (B), Kollert, Florian Kim, Reichenbach, Stephan, Villiger, Peter Matthias |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1462-0324 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Andrea Flükiger-Flückiger |
Date Deposited: |
16 Jun 2021 10:06 |
Last Modified: |
20 Feb 2024 14:16 |
Publisher DOI: |
10.1093/rheumatology/keab484 |
PubMed ID: |
34117737 |
Uncontrolled Keywords: |
Giant cell arteritis glucocorticoids tocilizumab ultrasound vascular response vasculitis |
BORIS DOI: |
10.48350/156887 |
URI: |
https://boris.unibe.ch/id/eprint/156887 |
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