Table 1

Treatment schedule, PET/CT, ESR results and remission rate at different time frames

TimingTreatmentRemission N (%)Flares*PET/CT and ESR† results‡
SUV max (±SD)P valueTBR (±SD)P valueTVS (±SD)P valueESRP value
BaselinePDN 50 mg/day for 1 week
PDN 10 mg dose reduction for 3 weeks and 5 mg for 4 weeks
15 patients enrolled§¶
ivTCZ: 9 (60%)
18 month responders
ivTCZ 8 mg/kg/4 weeks or scTCZ 162 mg/weekscTCZ: 6 (40%)18 month non-responders
Month 2PDN interruption
ivTCZ 8 mg/kg/4 weeks or scTCZ 162 mg/week
15 (100)None
Month 6ivTCZ 6 mg/kg/4 weeks or scTCZ 162 mg/2 weeks15 (100)None18 month responders
18 month non-responders
Month 8ivTCZ 4 mg/kg/4 weeks or scTCZ 162 mg/every 3 weeks15 (100)None
Month 10ivTCZ 2 mg/kg/4 weeks or scTCZ 162 mg/4 weeks.15 (100)None
Month 12TCZ interruption15 (100)None
Month 1418 month responders
18 month non-responders
Month 18Off-therapy remission assessment10 (66.7)Month 13: 1
Month 14: 1
Month 15: 2
Month 16: 1
  • *Flare definition: recurrence of GCA signs and symptoms with raised ESR at any time of treatment.

  • †Due to the known lowering effect of TCZ on CRP, only ESR was evaluated.

  • ‡PET/CT and ESR results at months 6 and 14 were compared with baseline values (analysis of variance).

  • §New diagnosis: 11 patients.

  • ¶Refractory GCA:four patients (previous mean CS treatment duration: 14±5.7 months; none had received methotrexate). Refractory GCA definition: recurrence of GCA signs and symptoms with raised ESR or CRP or both, at any time of CS tapering after initial response to higher doses.

  • CRP, C-reactive protein; CS, corticosteroids; ESR, erythrocyte sedimentation rate; GCA, giant cell arteritis; PDN, prednisone; PDN, prednisone; PET, positron emission tomography; SUVmax, standardised uptake value maximal; TBR, target to background ratio; TCZ, tocilizumab; TVS, total vascular score; ivTCZ, intravenous tocilizumab; scTCZ, subcutaneous tocilizumab.