AB1318 EFFECTIVENESS OF TOCILIZUMAB IN AORTITIS AND ANEURYSMS ASSOCIATED WITH GIANT CELL ARTERITIS. MULTICENTER OPEN-LABEL STUDY
Authors: A. Martín-Gutiérrez, J. Loricera, C. Secada-Gómez, I. Hernández-Rodríguez, S. Romero-Yuste, E. De Miguel, E. Galíndez-Agirregoikoa, I. Ferraz-Amaro, J. Sanchez-Martin, P. Moya, C. Campos Fernández, F. López-Gutiérrez, S. Castañeda, R. Blanco
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Giant Cell Arteritis (GCA) was initially described involving mainly the extracranial branches of the carotid arteries. However, GCA also may involve the aorta (GCA-aortitis) and its major branches, that may lead to severe complications such as aortic aneurysms, with the consequent risk of dissection with a high mortality. Tocilizumab (TCZ) was approved in GCA, but the efficacy in GCA-aortitis and aneurysms has not been specifically analyzed. <h3>Objectives:</h3> To assess the effectiveness and safety of TCZ in a wide series of GCA-aortitis and aneurysms. <h3>Methods:</h3> Multicentre observational study with GCA-aortitis treated with TCZ. GCA was diagnosed by: <b>a</b>) ACR criteria, <b>b</b>) temporal artery biopsy, and/or <b>c</b>) imaging techniques. Aortitis was diagnosed mainly by PET/CT. Main outcomes were: 1) effectiveness of TCZ in GCA-aortitis, 2) in preventing the growth of GCA-aortitis aneurysm and 3) the development of new aneurysms. EULAR remission is the absence of clinical symptoms and systemic inflammation and imaging remission is considered when vascular FDG uptake was less than liver uptake in PET/CT. <h3>Results:</h3> 471 patients with GCA treated with TCZ were reviewed. 196 of them had aortitis. We focused on 95 patients which had a baseline and follow-up imaging test. Figure 1. After 6 months, 60 (74.1%) reached EULAR remission but only, 1 (10%) an imaging remission; increasing up-to 83.3% and 27.5%, respectively, at 24 months. Figure 2. Aneurysms were present in 10 of 196 (5.1%) patients. Of the remaining patients without aneurysm, no patient on TCZ therapy developed aneurysms during follow-up. <h3>Conclusion:</h3> In GCA-aortitis patients 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. Moreover, TCZ does not seem to prevent aneurysm growth in those with structural damage already stablished. <h3>REFERENCES:</h3> [1] Prieto Peña D, Martínez-Rodríguez I, Atienza-Mateo B, Calderón-Goercke M, Banzo I, González-Vela MC, et al. Evidence for uncoupling of clinical and 18-FDG activity of PET/CT scan improvement in tocilizumab-treated patients with large-vessel giant cell arteritis. Clin Exp Rheumatol 2021;39:69–75. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Adrián Martín-Gutiérrez: None declared, Javier Loricera Roche, Galápagos, Novartis, UCB Pharma, MSD, Celgene, Astra Zeneca, and Grünenthal and received support for attending meetings and/or travel from Janssen, Abbvie, Roche, Novartis, MSD, UCB Pharma, Celgene, Lilly, Pfizer, Galápagos., Carmen Secada-Gómez: None declared, Iñigo Hernández-Rodríguez AbbVie, Amgen, Janssen, Merck Sharp &amp; Dohme, Novartis, Sanofi, Pfizer, UCB y Galápagos, Susana Romero-Yuste Abbvie, Astra-Zeneca, Bristol, Janssen, Lilly, Roche, Sandoz, Sanofi, UCB., Eugenio De Miguel Abbvie, Novartis, Pfizer, Roche, Janssen, Lilly, MSD, BMS, UCB, Grunental and Sanofi, Eva Galíndez-Agirregoikoa: None declared, Iván Ferraz-Amaro Abbvie, Pfizer, Roche, Sanofi, Celgene, and MSD, Abbvie, MSD, Janssen, and Roche, Julio Sanchez-Martin: None declared, Patricia Moya: None declared, Cristina Campos Fernández: None declared, Fernando López-Gutiérrez Janssen, Abbvie, Roche, Novartis, MSD, UCB Pharma, Celgene, Lilly, Pfizer, Galápagos., Santos Castañeda BMS, Eli-Lilly, Roche, Gedeon-Richter, Grünenthal Pharma and UCB, MSD and Pfizer. professor of the cátedra EPID-Future, funded by UAM-Roche, Ricardo Blanco AbbVie, Pfizer, Roche, GSK, Lilly, UCB, Bristol-Myers, Novartis, Janssen, UCB and MSD, AbbVie, MSD, and Roche.