Tocilizumab in visual involvement of giant cell arteritis : a multicenter study of 471 patients
Loricera, Javier
Castañeda, Santos
Moriano, Clara
Narváez, Javier (Hospital Universitari de Bellvitge)
Aldasoro, Vicente
Maiz, Olga
Melero, Rafael
Villa, Ignacio
Vela, Paloma
Romero-Yuste, Susana
Callejas Rubio, Jose Luis
de Miguel, Eugenio
Galíndez Agirregoikoa, Eva
Sivera, Francisca
Fernández-López, Jesús C.
Galisteo Lencastre Da Veiga, Carlos (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Ferraz-Amaro, Iván
Sánchez-Martín, Julio
Sánchez-Bilbao, Lara
Calderón-Goercke, Mónica
Casado, Alfonso
Hernández, José L.
Gonzalez-Gay, MA
Blanco, Ricardo
Universitat Autònoma de Barcelona

Data:	2022
Resum:	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. 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. This is an observational multicenter study of patients with GCA treated with TCZ. 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. 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. 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.
Ajuts:	Ministerio de Economía y Competitividad RD16/0012/0009
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Giant cell arteritis ; Large-vessel vasculitis ; Tocilizumab ; Visual involvement
Publicat a:	Therapeutic Advances in Musculoskeletal Disease, Vol. 14 (july 2022) , ISSN 1759-7218

DOI: 10.1177/1759720X221113747
PMID: 35898567

16 p, 998.9 KB

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