%0 Journal Article
%T Effectiveness Of Tocilizumab In Aortitis And Aneurysms Associated With Giant Cell Arteritis.
%A Martín-Gutiérrez A
%A Loricera J
%A Narváez J
%A Aldasoro V
%A Maiz O
%A Vela P
%A Romero-Yuste S
%A de Miguel E
%A Galíndez-Agirregoikoa E
%A Fernández-López JC
%A Ferraz-Amaro I
%A Sánchez-Martín J
%A Moya P
%A Campos C
%A López-Gutiérrez F
%A Castañeda S
%A Blanco R
%A  
%J Eur J Intern Med
%V 0
%N 0
%D 2024 Jun 21
%M 38908981
%F 7.749
%R 10.1016/j.ejim.2024.06.013
%X <B>OBJECTIVE: </B>Aortitis in Giant Cell Arteritis (GCA-aortitis) is a frequent complication that may lead to aneurysms. Tocilizumab (TCZ) was approved in GCA, but the efficacy in GCA-aortitis and aneurysms has not been analyzed to date. Our aim was to assess the effectiveness and safety of TCZ in a wide series of GCA-aortitis and aneurysms.<BR><B>METHODS: </B>Multicentre observational study with GCA-aortitis treated with TCZ. GCA was diagnosed by: a) ACR criteria, b) temporal artery biopsy, and/or c) imaging techniques. Aortitis was diagnosed mainly by PET/CT. Main outcomes were EULAR and imaging remission. Others were clinical remission, analytical normalization, corticosteroid-sparing effect, and the prevention and improvement of aneurysms.<BR><B>RESULTS: </B>196 patients with GCA-aortitis treated with TCZ. After 6 months, 72.2% reached EULAR remission but only 12% an imaging remission; increasing up-to 81.4% and 31.8%, respectively, at 24 months. A rapid clinical remission, ESR and CRP normalization was observed in 47.4%, 84.3% and 55.6%, at 1 month, increasing to 89.6%, 85.3% and 80.3% at 24 months, respectively. Aneurysms were present in 10 (5%) patients. Five of them required early surgery, while 3 others enlarged. No patient on TCZ therapy developed aneurysms during follow-up.<BR><B>CONCLUSIONS: </B>In patients with GCA-aortitis treated with TCZ, a rapid and maintained clinical and analytical improvement was observed. However, there was an uncoupling between clinical and EULAR remission with imaging remission.