Prolonged tocilizumab treatment needed to suppress GCA inflammation
medwireNews: An analysis of inflammatory markers suggests that patients with giant cell arteritis (GCA) who are treated with tocilizumab still have subclinical disease activity during early remission, but not after 1 year of treatment.
The researchers analyzed data from 14 patients who were treated with tocilizumab 8 mg/kg every 4 weeks and achieved lasting clinical remission for 1 year, finding that levels of matrix metalloproteinase (MMP)-3, pentraxin-3, and soluble tumor necrosis factor receptor type 2 (sTNFR-2) remained elevated after 12 weeks of treatment, “despite complete remission of disease.”
However, after 1 year, tocilizumab treatment “resulted in an almost complete normalization of immune–inflammatory molecules,” report Peter Villiger (University of Bern, Switzerland) and colleagues in Rheumatology.
By this timepoint, average levels of MMP-3 and pentraxin-3 were not significantly different among the 14 GCA patients and the same number of age- and sex-matched healthy controls, although sTNFR-2 levels remained significantly elevated. Intercellular adhesion molecule 1 concentrations were significantly lower in tocilizumab-treated patients versus controls at both weeks 12 and 52.
These findings suggest that “tocilizumab treatment of at least 52 weeks is necessary in order to reset a broad range of immune–inflammatory pathways,” say the study authors.
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