Tocilizumab for the treatment of giant cell arteritis

ABSTRACT

Introduction: Giant cell arteritis (GCA) is the most frequent type of vasculitis, occurring in people older than 50 years. So far, treatment has been limited to corticosteroids and methotrexate only.

Areas covered: Interleukin-6 (IL-6) plays a role in the pathophysiology of GCA. This review covers recent advances in the treatment of GCA with tocilizumab (TCZ), which specifically binds to both soluble and membrane-bound IL-6R and inhibits IL-6R-mediated signaling.

Expert commentary: Two randomized controlled trials recently showed the efficacy of the IL-6 receptors inhibitor monoclonal antibody TCZ for the induction and maintenance of remission in patients with new-onset and relapsing GCA. Furthermore, addition of TCZ to prednisone led to a reduction in the cumulative prednisone doses required to control GCA. The profile of adverse events was balanced across treatment groups and no safety concerns were raised during the trial.

KEYWORDS:

• Giant cell arteritis
• biological disease-modifying anti rheumatic drug
• interleukin-6
• large vessel arteritis
• tocilizumab
• interleukin-6 receptor

Information resources

RoActemra prescribing information (http://www.ema.europa.eu/docs/de_de/document_library/EPAR_-_Product_Information/human/000955/WC500054890.pdf)

Pubmed (https://www.ncbi.nlm.nih.gov/pubmed)

Clinical trials.gov registry and database of clinical studies of human participants (https://clinicaltrials.gov)

Declaration of interest

M Schirmer has received honoraria for congress participation and an educational grant from Roche, Austria. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. One peer reviewer for this manuscript has received lecture fees from Roche. Roche provided a scientific accuracy review at the request of the journal editor.

Additional information

Funding

This article was funded by Medizinische Universitat Innsbruck (Austria) and Azienda Osped SMN, Reggio Emilia (Italy).