Tocilizumab in visual involvement of giant cell arteritis: a multicenter study of 471 patients

Background: Visual involvement is the most feared complication of giant cell arteritis (GCA). Information on the efficacy of tocilizumab (TCZ) for this complication is scarce and controversial. Objective: We assessed a wide series of GCA treated with TCZ, to evaluate its role in the prevention of ne...

ver descrição completa

Detalhes bibliográficos
Autores: Loricera, J, Castaneda, S, Moriano, C, Narvaez, J, Aldasoro, V, Maiz, O, Melero, R, Villa, I, Vela, P, Romero-Yuste, S, Callejas, JL, de Miguel, E, Galindez-Agirregoikoa, E, Sivera, F, Fernandez-Lopez, JC, Galisteo, C, Ferraz-Amaro, I, Sanchez-Martin, J, Sanchez-Bilbao, L, Calderon-Goercke, M, Casado, A, Hernandez, JL, Gonzalez-Gay, MA, Blanco, R
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Recursos:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p1312
Acesso em linha:https://i3pt.portalinvestigacion.com/publicaciones/1312
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85135090195&doi=10.1177%2f1759720X221113747&partnerID=40&md5=e54dca26cfe3a58870e68bd5f8d7cc85
Access Level:acceso abierto
Palavra-chave:giant cell arteritis
large-vessel vasculitis
tocilizumab
visual involvement
Descrição
Resumo:Background: Visual involvement is the most feared complication of giant cell arteritis (GCA). Information on the efficacy of tocilizumab (TCZ) for this complication is scarce and controversial. Objective: We assessed a wide series of GCA treated with TCZ, to evaluate its role in the prevention of new visual complications and its efficacy when this manifestation was already present before the initiation of TCZ. Design: This is an observational multicenter study of patients with GCA treated with TCZ. Methods: Patients were divided into two subgroups according to the presence or absence of visual involvement before TCZ onset. Visual manifestations were classified into the following categories: transient visual loss (TVL), permanent visual loss (PVL), diplopia, and blurred vision. Results: Four hundred seventy-one GCA patients (mean age, 74 +/- 9 years) were treated with TCZ. Visual manifestations were observed in 122 cases (26%), of which 81 were present at TCZ onset: PVL (n = 60; unilateral/bilateral: 48/12), TVL (n = 17; unilateral/bilateral: 11/6), diplopia (n = 2), and blurred vision (n = 2). None of the patients without previous visual involvement or with TVL had new episodes after initiation of TCZ, while only 11 out of 60 (18%) patients with PVL experienced some improvement. The two patients with diplopia and one of the two patients with blurred vision improved. Conclusion: TCZ may have a protective effect against the development of visual complications or new episodes of TVL in GCA. However, once PVL was established, only a few patients improved.

Registos relacionados