Tocilizumab in visual involvement of giant cell arteritis: a multicenter study of 471 patients

Autor: Javier Loricera, Santos Castañeda, Clara Moriano, Javier Narváez, Vicente Aldasoro, Olga Maiz, Rafael Melero, Ignacio Villa, Paloma Vela, Susana Romero-Yuste, José L. Callejas, Eugenio de Miguel, Eva Galíndez-Agirregoikoa, Francisca Sivera, Jesús C. Fernández-López, Carles Galisteo, Iván Ferraz-Amaro, Julio Sánchez-Martín, Lara Sánchez-Bilbao, Mónica Calderón-Goercke, Alfonso Casado, José L. Hernández, Miguel A. González-Gay, Ricardo Blanco
Přispěvatelé: UAM. Departamento de Medicina, Universidad de Cantabria
Rok vydání: 2022
Předmět:
Zdroj: Dipòsit Digital de la UB
Universidad de Barcelona
Ther Adv Musculoskelet Dis . 2022 Jul 22;14:1759720X221113747
THERAPEUTIC ADVANCES IN MUSCULOSKELETAL DISEASE
r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname
ISSN: 1759-720X
Popis: 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±9years) 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.
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was partially supported by RETICS Program (RD16/0012/0009) (Instituto de Salud Carlos III, co-funded by the European Regional Development Fund) from ‘Instituto de Salud Carlos III’ (ISCIII) (Spain).
Databáze: OpenAIRE
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