0465: Tocilizumab in Large-Vessel Giant Cell Arteritis and Takayasu Arteritis: Multicentric Observational Comparative Study

Diana Prieto-Peña¹, Javier Loricera², Santos Castañeda³, Clara Moriano⁴, Pilar Bernabeu⁵, Paloma Vela-Casampere⁶, F. Javier Narváez⁷, Vicente Aldasoro⁸, Olga Maíz⁹, Jesús Carlos Fernández-López¹⁰, Mercedes Freire¹⁰, Rafael Melero¹¹, Juan Ignacio Villa¹², Beatriz Gonzalez-Alvarez¹³, Roser Solans-Laqué¹⁴, José Luis Callejas¹⁵, Carlos Fernandez-Diaz¹⁶, Salvador Garcia-Morillo¹⁷, Mauricio Minguez¹⁸, Cristina Fernández-Carballido¹⁹, Esteban Rubio²⁰, Eugenio De Miguel²¹, Julio Sánchez-Martín²², Esther Fernandez²³, Sheila Melchor²⁴, Eva Salgado-Pérez²⁵, Beatriz Bravo²⁶, Susana Romero Yuste²⁷, Eva Galíndez-Agirregoikoa²⁸, francisca Sivera²⁹, Ivan Ferraz Amaro³⁰, Cristina Hidalgo³¹, Carlos Romero Gomez³², Carles Galisteo³³, Patricia Moya Alvarado³⁴, Noelia Alvarez-Rivas³⁵, Javier Mendizabal³⁶, Juan Carlos Nieto González³⁷, Juan Ramón de Dios³⁸, Jose Luis Andreu³⁹, Nagore Fernandez-Llanio⁴⁰, Eztizen Labrador⁴¹, Enrique Raya Álvarez⁴², Arantxa Conesa⁴³, Francisco Ortiz-Sanjuan⁴⁴, Sara Manrique Arija³², Iñigo Rua-Figueroa⁴⁵, A. García-valle⁴⁶, Miguel Ángel González-Gay⁴⁷ and Ricardo Blanco², ¹Research Group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL; and Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain, ²Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, ³Division of Rheumatology, Hospital Universitario de La Princesa, IIS-Princesa, Madrid, Spain, ⁴Complejo Asistencial Universitario de León, León, Spain, ⁵Hospital General de Alicante, Alicante, Spain, ⁶Hospital General Universitario Alicante, Alicante, Spain, ⁷Rheumatology Department, Hospital Universitario de Bellvitge, Barcelona, Spain, ⁸Hospital Universitario de Navarra, Pamplona, Spain, ⁹Hospital Univesitario de Donostia, Donostia, Spain, ¹⁰Complejo H. Universitario de A Coruña, A Coruña, Spain, ¹¹Complexo Hospitalario Universitario de Vigo, Vigo, Spain, ¹²Hospital Sierrallana, Torrelavega, Spain, ¹³Hospital Nuestra Señora de la Candelaria, Tenerife, Spain, ¹⁴Hospital Vall d’Hebron, Barcelona, Spain, ¹⁵Hospital San Cecilio, Granada, Spain, ¹⁶H, Murcia, Spain, ¹⁷Hospital Virgen del Rocío, Sevilla, Spain, ¹⁸San Juan de Alicante, Alicante, Spain, ¹⁹Agencia Valenciana de Salud, Alicante, Spain, ²⁰HOSPITAL UNIVERSITARIO VIRGEN DEL ROCIO, SEVILLE, Spain, ²¹Hospital Universitario La Paz, Madrid, Spain, ²²Hospital Universitario Marqués de Valdecilla, Santander, Spain, ²³Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain, ²⁴Hospital Universitario 12 de Octubre, Madrid, Spain, ²⁵Complejo Hospitalario Universitario de Ourense, Santiago de Composte, Spain, ²⁶Hospital Virgen de las Nieves, Madrid, Spain, ²⁷Complexo Hospitalario Universitario, Pontevedra, Spain, ²⁸Basurto University Hospital, Bilbao, Spain, ²⁹Hospital Universitario de Elda, Alicante, Spain, ³⁰Division of Rheumatology. Hospital Universitario de Canarias. Spain., Santa Cruz de Tenerife, Spain, ³¹Hospital Universitario Salamanca, Salamanca, Spain, ³²Hospital Regional Universitario Málaga, Málaga, Spain, ³³Hospital Parc Tauli,, Sabadel, Spain, ³⁴Hospital Parc Tauli, Barcelona, Spain, ³⁵Hospital San Agustin, Aviles, Spain, ³⁶Complejo Hospitalario de Navarra,, Pamplona, Spain, ³⁷Hospital General Universitario Gregorio Marañón, Madrid, Spain, ³⁸Hospital de Araba, Araba, Spain, ³⁹Hospital Puerta de Hierro, Madrid, Spain, ⁴⁰Hospital Arnau de Vilanova,, València, Spain, ⁴¹Hospital San Pedro, Logroño, Spain, ⁴²Hospital Universitario San Cecilio, Granada, Spain, ⁴³Hospital Universitario de Castellón, València, Spain, ⁴⁴Hospital Universitario de La Fe, València, Spain, ⁴⁵Hospital Doctor Negrín, Gran Canaria, Spain, ⁴⁶Completo Asistencial Palencia, Palencia, Spain, ⁴⁷Department of Medicine and Psychiatry, Universidad de Cantabria; Rheumatology Division, Hospital Universitario Marqués de Valdecilla; Research group on genetic epidemiology and atherosclerosis in systemic diseases and in metabolic diseases of the musculoskeletal system, IDIVAL, Santander, Spain. Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Background/Purpose: Tocilizumab (TCZ) has shown to be effective for large vessel vasculitis including giant cell arteritis (GCA) and Takayasu arteritis (TAK). However, LVV-GCA and TAK show different demographic and clinical features that may influence on TCZ therapeutic response. Our aim was to compare the efficacy of TCZ in patients with LVV-GCA and patients with TAK.

Methods: Observational multicenter study of patients with LVV-GCA and TAK who received TCZ. Outcome variables were: a) proportion of patients who achieved complete clinical improvement along with normalization of laboratory markers (CRP ≤0.5mg/dL and/or ESR ≤ 20 mm/1st hour) at 12 months b) complete improvement in imaging techniques. A comparative study between patients with LVV-GCA and TAK was performed.

Results: We evaluated 70 LVV-GCA and 57 TAK patients who received TCZ. Main clinical and demographic characteristic are described in Table. Patients with TAK were younger, had longer disease duration, had received more commonly previous biologic therapy and were receiving higher doses of prednisone at baseline. TCZ intravenous administration was more common in TAK patients (80.7% vs 48.6%; p< 0.01). Follow-up time after TCZ onset was similar in both groups. At 12 months, about 75% of patients achieved complete clinical improvement and ESR/CRP normalization in both groups. A follow-up imaging technique was performed in 37 LVV-GCA patients after a mean time of 12.9±6.0 months and 38 TAK patients after 9.5±5.0 months. Complete improvement in imaging techniques was only observed in 18.9% and 21.1% of patients with LVV-GCA and TAK, respectively (figure).

Conclusion: The efficacy of TCZ was similar in patients with LVV-GCA and TAK, despite a more refractory disease in TAK patients. A discordance between clinical and imaging activity improvement was observed in both LVV-GCA and TAK, as reported in previous studies.
Table

Figure
Disclosures: D. Prieto-Peña, UCB, Roche, Pfizer, Amgen, Janssen, AbbVie/Abbott, Novartis, Eli Lilly; J. Loricera, Novartis, UCB, Celgene, Roche; S. Castañeda, Roche; C. Moriano, None; P. Bernabeu, None; P. Vela-Casampere, None; F. Narváez, None; V. Aldasoro, None; O. Maíz, None; J. Fernández-López, None; M. Freire, None; R. Melero, None; J. Villa, None; B. Gonzalez-Alvarez, None; R. Solans-Laqué, None; J. Callejas, None; C. Fernandez-Diaz, None; S. Garcia-Morillo, None; M. Minguez, None; C. Fernández-Carballido, None; E. Rubio, None; E. De Miguel, None; J. Sánchez-Martín, None; E. Fernandez, None; S. Melchor, None; E. Salgado-Pérez, None; B. Bravo, None; S. Romero Yuste, Pfizer, Lilly, AbbVie, Biogen, Sanofi; E. Galíndez-Agirregoikoa, None; f. Sivera, None; I. Ferraz Amaro, AbbVie/Abbott, Merck/MSD, Janssen, Roche, AbbVie/Abbott, Pfizer, Roche, Amgen, Celgene, Merck/MSD; C. Hidalgo, None; C. Romero Gomez, None; C. Galisteo, None; P. Moya Alvarado, None; N. Alvarez-Rivas, None; J. Mendizabal, None; J. Nieto González, None; J. de Dios, None; J. Andreu, None; N. Fernandez-Llanio, None; E. Labrador, None; E. Raya Álvarez, None; A. Conesa, None; F. Ortiz-Sanjuan, None; S. Manrique Arija, None; I. Rua-Figueroa, None; A. García-valle, None; M. González-Gay, AbbVie/Abbott, Merck/MSD, Janssen, Roche, AbbVie/Abbott, Roche, Sanofi, Eli Lilly, Celgene, Sobi, Merck/MSD; R. Blanco, Eli Lilly, Pfizer, Roche, Janssen, MSD, AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb, Galapagos, Novartis, Sanofi.