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Remission maintenance after tocilizumab dose-tapering and interruption in patients with giant cell arteritis: an open-label, 18-month, prospective, pilot study
  1. Carlotta Nannini1,
  2. Laura Niccoli1,
  3. Stelvio Sestini2,
  4. Iashar Laghai2,
  5. Angela Coppola2,
  6. Fabrizio Cantini1
  1. 1 Department of Rheumatology, Hospital of Prato, Prato, Italy
  2. 2 Department of Nuclear Medicine, Hospital of Prato, Prato, Italy
  1. Correspondence to Dr Fabrizio Cantini, Department of Rheumaotlogy, Hospital of Prato, Prato 59100, Italy; fbrzcantini{at}gmail.com

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In the GiACTA trial,1 tocilizumab (TCZ) combined with prednisone (PDN) was significantly superior to PDN alone to obtain the remission in patients with giant cell arteritis (GCA) with and without concomitant large vessel vasculitis (LVV). To date, no data on the management of patients achieving the remission with TCZ monotherapy after a short course of combined treatment with CS are available.

To investigate the persistence of remission after TCZ interruption, we designed an open-label, prospective trial of 15 consecutive patients meeting the American College of Rheumatology 1990 criteria for GCA.2 Four patients had refractory GCA and 11 were new diagnoses (clinical and demographic data: see online supplementary table S1). All had concomitant thoracic LVV evidenced by 18-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT. Total vascular score (TVS), maximal standardised uptake value (SUVmax) and target to background ratio …

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Footnotes

  • Handling editor Prof Josef S Smolen

  • Contributors FC, CN and LN equally contributed to the study design projecting, patients’ recruitment and management, statistical analysis and manuscript writing. SS, IL and AC performed and evaluated the PET/CT results and reviewed the manuscript. All revised and corrected the manuscript.

  • Competing interests No, there are no competing interests for any author.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the local ethical committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.