Efficacy of tocilizumab in refractory giant cell arteritis.

Abstract

Giant cell arteritis is the most frequent form of vasculitis characterized by a high risk of vascular thrombosis. Major complications are blindness and other vascular ischemia but bowel ischemic involvement is rare. Treatment is based on long-term steroid therapy with numerous side effects. The efficacy of immunosuppressive drugs like azathioprine methotrexate or anti-tumor necrosis factor antibodies appears to be too low to reduce the use of steroids. Th17 lymphocytes and interleukin-6 play an important role in pathogenesis of giant cell arteritis. We report here a case of effective interleukin-6 blocker in the treatment of refractory giant cell arteritis with ileitis and high-dose steroid dependence despite 2 years of treatment with steroids and methotrexate. After infusions of tocilizumab, no relapse at 6 months was found despite the decrease in corticosteroids.

• Authors: Julien Vinit, Philip Bielefeld, Géraldine Muller, Jean-François Besancenot
• Journal: Joint bone spine (Joint Bone Spine) Vol. 79 Issue 3 Pg. 317-8 (May 2012) ISSN: 1778-7254 [Electronic] France
• PMID: 22284606 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2011 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Chemical References

• Antibodies, Monoclonal, Humanized
• IL6 protein, human
• Immunosuppressive Agents
• Interleukin-6
• tocilizumab

Topics

• Antibodies, Monoclonal, Humanized (therapeutic use)
• Drug Resistance
• Drug Therapy, Combination
• Female
• Giant Cell Arteritis (drug therapy, immunology)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Interleukin-6 (antagonists & inhibitors)
• Middle Aged
• Secondary Prevention