Main finding: Tocilizumab combined with a 26-week prednisone taper was superior to either 26-week or 52-week prednisone tapering plus placebo in sustained glucocorticoid-free remission in GCA patients.
Purpose: To study the effect of the interleukin-6 receptor alpha inhibitor tocilizumab on the rates of relapse during glucocorticoid tapering in patients with giant-cell arteritis.
Study type: Randomized controlled trial
Condition: Giant Cell Arteritis
Participants: GCA proven on temporal artery biopsy or on imaging (CTA/MRA/PET)
n=251
Intervention:
Group 1: tocilizumab weekly + 26-wk Prednisone taper
Group 2: tocilizumab q2weekly + 26-wk Prednisone taper
Group 3: placebo + 26-wk Prednisone taper Group 4: placebo + 52-wk Prednisone taper
At 52 weeks, sustained remission occurred in 56% of patients treated with tocilizumab weekly and in 53% of those treated with tocilizumab every fortnight vs 14% of patients that underwent the 26-week prednisone taper and 18% of those that underwent the 52-week prednisone taper.
Outcome
Group 1 (Toci weekly + Pred 26w)
Group 2 (Toci 2weekly + Pred 26w)
Group 3 (Pred 26w)
Group 4 (Pred 52w)
Sustained remission (Proportion)
56%
53%
14%
18%
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