Vision loss in patients with giant cell arteritis treated with tocilizumab
| Autor: | Godehard Scholz, Jennifer Amsler, Odile Stalder, Lisa Christ, Christoph Tappeiner, Iveta Kysela, Luca Seitz, Peter M. Villiger, Stephan Reichenbach, Florian Kollert |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty lcsh:Diseases of the musculoskeletal system genetic structures 610 Medicine & health Antibodies Monoclonal Humanized chemistry.chemical_compound Tocilizumab Vision loss Internal medicine medicine Humans In patient Glucocorticoids Giant cell arteritis business.industry Incidence (epidemiology) medicine.disease Rheumatology eye diseases Anterior ischemic optic neuropathy (AION) Treatment Outcome chemistry Concomitant Cohort Orthopedic surgery Female lcsh:RC925-935 business Research Article |
| Zdroj: | Arthritis Research & Therapy, Vol 23, Iss 1, Pp 1-8 (2021) Amsler, Jennifer; Kysela, Iveta; Tappeiner, Christoph; Seitz, Luca; Christ, Lisa; Scholz, Godehard; Stalder, Odile; Kollert, Florian; Reichenbach, Stephan; Villiger, Peter (2021). Vision loss in patients with giant cell arteritis treated with tocilizumab. Arthritis research & therapy, 23(1), p. 92. BioMed Central 10.1186/s13075-021-02480-4 Arthritis Research & Therapy |
| ISSN: | 1478-6362 |
| DOI: | 10.1186/s13075-021-02480-4 |
| Popis: | Objectives Giant cell arteritis (GCA) may lead to vision loss. To what extent tocilizumab (TCZ) is able to prevent vision loss is unknown. The aim was to analyze the occurrence of vision loss in a large GCA cohort treated with TCZ. Methods In this observational monocentric study, GCA patients treated with TCZ between the years 2010 and 2018 were studied. Demographic, clinical, and laboratory data were analyzed. Results A total of 186 patients were included (62% female); 109 (59%) fulfilled the American College of Rheumatology (ACR) criteria, in 123 (66%) patients, large vessel vasculitis was diagnosed by magnetic resonance-angiography (MRA). Cumulative duration of TCZ treatment was 224 years, median treatment duration was 11.1 (IQR 5.6–17.9) months. Glucocorticoids (GC) were tapered over a median of 5.8 (IQR 3.0–8.5) months. At baseline, visual symptoms were present in 70 (38%) and vision loss in 21 (11%) patients. Patients with vision loss at baseline were older (p = 0.032), had a lower C-reactive protein (p = 0.002), and showed a negative association with MRA of the aorta (p = 0.006). Two patients (1.1%) developed vision loss, both at the initiation of TCZ treatment. Conclusion Our data show a very low incidence of vision loss in TCZ-treated patient. The two cases of AION occurred at the initiation of therapy, they support the hypothesis that advanced, and established structural changes of arteries are key factors for this accident. Whether a shorter duration of concomitant GC treatment is risky regarding vision loss needs to be studied. |
| Databáze: | OpenAIRE |
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