ArticleRMD open2024
Does tocilizumab eliminate inflammation in GCA? A cohort study on repeated temporal artery biopsies.
Article in RMD open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Efficacy of tocilizumab monotherapy after ultrashort glucocorticoid administration to treat giant cell arteritis: three-year follow-up.Rheumatology (Oxford, England) · 2025Trial
- Treatment strategies in giant cell arteritis and polymyalgia rheumatica: beyond glucocorticoids.Nature reviews. Rheumatology · 2026Review
- Challenges and Future Trends in Large Vessel Vasculitis.Circulation · 2026Review
- Cranial and Systemic Manifestations of Giant Cell Arteritis: Two Sides of the Same Coin.Cureus · 2026Article
- The Role of FDG-PET in the Diagnosis and Monitoring of Large-Vessel Vasculitis.Current rheumatology reports · 2025Review
- Uncovering the New Biology of Giant Cell Arteritis to Guide Therapeutic Strategies.Journal of clinical medicine · 2025Review
- Dynamic macrophage phenotypes in autoimmune and inflammatory rheumatic diseases.Nature reviews. Rheumatology · 2025Review
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Authors and funding
14 authors.
Funding
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Abstract
backgroundVascular inflammation persists in temporal artery biopsy (TAB) of giant cell arteritis (GCA) patients even after prolonged glucocorticoid (GC) therapy. We aimed to evaluate the histological impact of adding tocilizumab (TCZ) to GCs.
methodsWe enrolled all consecutive GCA patients with an inflammed TAB at diagnosis who were treated with TCZ and GCs for ≥6 months and followed from December 2017 to December 2023. Within 2 weeks, all patients underwent a second TAB, positron emission 18-fluorodeoxyglucose tomography/CT (PET/CT) and vessel colour Doppler ultrasonography (CDUS). Results were compared with pretreatment findings.
results13 patients repeated TAB after a median TCZ treatment of 2.4 years (Q1-Q3: 1.2-3.9 years). The first TAB showed transmural inflammation (TMI) in 11/13 patients (84.6%), inflammation limited to adventitia (ILA) in one patient (7.7%) and small vessel vasculitis (SVV) in another (7.7%). On repeated TABs, five patients (38.5%) still showed some degree of inflammation. Among the 11 patients with initial TMI, 2 had ILA, 1 had TMI, 1had SVV and 1 had vasa vasorum vasculitis at the second TAB. Nine patients had active vasculitis at baseline PET/CT, and three (33.3%) still showed activity at the last PET/CT, with a relevant reduction in mean PET vascular activity score (-6.5; 95% CI 1.54 to 11.45; p=0.017). The repeated quantitative CDUS revealed altered parameters suggestive of vasculitis in temporal arteries in about one-third of the patients.
conclusionOur study, using pathological and imaging assessments, revealed that after TCZ and GCs, over one-third of patients still presented with vascular inflammation.
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