0146: Intravenous versus Subcutaneous Tocilizumab in a Series of 471 Patients with Giant Cell Arteritis

Lara Sánchez-Bilbao¹, Javier Loricera², Santos Castañeda³, Clara Moriano⁴, F. Javier Narváez⁵, Vicente Aldasoro⁶, Olga Maiz⁷, Rafael Melero⁸, Juan Ignacio Villa⁹, Paloma Vela-Casampere¹⁰, Susana Romero Yuste¹¹, José Luis Callejas¹², Eugenio De Miguel¹³, Eva Galíndez-Agirregoikoa¹⁴, Francisca Sivera¹⁵, Jesús Carlos Fernández-López¹⁶, Carles Galisteo¹⁷, Ivan Ferraz Amaro¹⁸, Julio Sánchez-Martín¹, Mónica Calderón-Goercke¹, José Luis Hernández¹, Miguel Ángel González-Gay¹⁹ and Ricardo Blanco², ¹Hospital 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, ⁵Rheumatology Department, Hospital Universitario de Bellvitge, Barcelona, Spain, ⁶Hospital Universitario de Navarra, Pamplona, Spain, ⁷Hospital Universitario de Donostia, San Sebastián, Spain, ⁸Complexo Hospitalario Universitario de Vigo, Vigo, Spain, ⁹Hospital Sierrallana, Torrelavega, Spain, ¹⁰Hospital General Universitario Alicante, Alicante, Spain, ¹¹Complexo Hospitalario Universitario, Pontevedra, Spain, ¹²Hospital San Cecilio, Granada, Spain, ¹³Hospital Universitario La Paz, Madrid, Spain, ¹⁴Basurto University Hospital, Bilbao, Spain, ¹⁵Hospital Universitario de Elda, San Vicente del Raspeig, Spain, ¹⁶Complejo H. Universitario de A Coruña, A Coruña, Spain, ¹⁷Hospital Parc Tauli,, Sabadel, Spain, ¹⁸Division of Rheumatology. Hospital Universitario de Canarias. Spain., Santa Cruz de Tenerife, Spain, ¹⁹Department 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 efficacy in large-vessel vasculitis, including Giant Cell Arteritis (GCA). Clinical trials with TCZ in GCA were performed with intravenous (iv) TCZ in a phase 2 trial, and with subcutaneous (sc) TCZ in the phase 3 GiACTA. However, in GCA there are no studies comparing IV vs SC TCZ.

Our aim was to compare the efficacy of TCZ in GCA patients according to the route of administration IV-TCZ vs SC-TCZ.

Methods: Multicentre study of 471 patients diagnosed with GCA and treated with TCZ. They were divided into 2 groups according to the route of administration: a) IV, and b) SC. GCA was diagnosed by: a) ACR criteria, and/or b) temporal artery biopsy, and/or c) imaging techniques. Sustained remission was established according to EULAR definitions.

Results: We studied 471 patients (mean age, 74 ±9 years) treated with TCZ, 238 with IV-TCZ and 233 with SC-TCZ (TABLE). The time between diagnosis of GCA and TCZ onset was shorter in the SC TCZ group. Regarding acute phase reactants at the beginning of TCZ, no differences were found between both groups. There were no significant differences in sustained remission or in glucocorticoid-sparing effect of TCZ (FIGURE). Patients on IV TCZ treatment suffered more relevant adverse effects during follow-up.

Conclusion: In GCA, TCZ seems equally effective and safe regardless of the route of administration IV or SC.




Disclosures: L. Sánchez-Bilbao, Eli Lilly; J. Loricera, Novartis, UCB, Celgene, Roche; S. Castañeda, Roche; C. Moriano, None; F. Narváez, None; V. Aldasoro, None; O. Maiz, None; R. Melero, None; J. Villa, None; P. Vela-Casampere, None; S. Romero Yuste, Pfizer, Lilly, AbbVie, Biogen, Sanofi; J. Callejas, None; E. De Miguel, None; E. Galíndez-Agirregoikoa, None; F. Sivera, None; J. Fernández-López, None; C. Galisteo, None; I. Ferraz Amaro, AbbVie/Abbott, Merck/MSD, Janssen, Roche, AbbVie/Abbott, Pfizer, Roche, Amgen, Celgene, Merck/MSD; J. Sánchez-Martín, None; M. Calderón-Goercke, None; J. Hernández, 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.