Tocilizumab Induces and Maintains Remission in Giant Cell Arteritis Save

Lancet has reported the results of a randomized, double-blind, placebo-controlled trial of tocilizumab in patients with new-onset giant cell arteritis (GCA). Thirty patients were randomized (2:1) to receive either tocilizumab (8 mg/kg) or placebo intravenously every 4 weeks for a year. All patients were initially treated with high-dose prednisolone (1 mg/kg/day) and weaned off using a standardized dose-reduction scheme.

Complete remission at week 12 was achieved in 17 (85%) of 20 patients given tocilizumab and four (40%) of 10 patients given placebo (p=0·03). Relapse-free survival was achieved in 17 (85%) patients in the tocilizumab group and two (20%) in the placebo group by week 52 (p=0·001).

Patients on TCZ were more likely to stop glucocorticoids at 12 weeks and had a lower cumulative prednisolone dose (43 mg/kg) compared to those on placebo (110 mg/kg) after 52 weeks of study. 

Serious adverse events were frequent in both groups (35% for TCZ and 50% for PBO) and were largely related to high dose steroids.

This is the first randomized trial do demonstrate the induction and remission efficacy of IL-6 inhibition with tocilizumab in patients with giant cell arteritis.