Pan American League of Associations for Rheumatology guidelines for the treatment of giant cell arteritis

Scolnik, Marina; Brance, Maria L; Fernández-Ávila, Daniel G.; Sato, Emília Inoue; Souza, Alexandre Wagner Silva de; Magri, Sebastián J; Saldarriaga-Rivera, Lina María; Ugarte‐Gil, Manuel F.; Flores‐Suárez, Luis Felipe; Babini, Alejandra; Zamora, Natalia; Felquer, María L Acosta; Vergara, Facundo; Carlevaris, Leandro; Scarafia, Santiago; Guppy, Enrique Roberto Soriano; Unizony, Sebastian

doi:10.1016/s2665-9913(22)00260-0

Cited by 5 publications

(4 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 17 20 Until those data are generated, the duration of treatment for GCA patients should be individualised as recommended by major rheumatological societies based on several factors including but not limited to the patient’s clinical course (eg, relapsing vs non-relapsing), the occurrence of treatment-related adverse events, the clinical judgement of the treating physician and the patient’s preferences. 21 22 …”

Section: Discussionmentioning

confidence: 99%

“…Further research is needed to identify those individuals at greater risk of relapse after early TCZ discontinuation to maintain therapy beyond 12 months and to investigate whether a step-down strategy reducing the dose of TCZ prior to treatment withdrawal could improve the outcomes after therapy cessation 17 20. Until those data are generated, the duration of treatment for GCA patients should be individualised as recommended by major rheumatological societies based on several factors including but not limited to the patient’s clinical course (eg, relapsing vs non-relapsing), the occurrence of treatment-related adverse events, the clinical judgement of the treating physician and the patient’s preferences 21 22…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes during and after long-term tocilizumab treatment in patients with giant cell arteritis

Matza

Dagincourt²,

Mohan³

et al. 2023

RMD Open

View full text Add to dashboard Cite

ObjectiveTo assess outcomes in giant cell arteritis (GCA) patients during and after long-term tocilizumab (TCZ) treatment.MethodsRetrospective analysis of GCA patients treated with TCZ at a single centre (2010–2022). Time to relapse and annualised relapse rate during and after TCZ treatment, prednisone use, and safety were assessed. Relapse was defined as reappearance of any GCA clinical manifestation that required treatment intensification, regardless of C reactive protein levels and erythrocyte sedimentation rate.ResultsSixty-five GCA patients were followed for a mean (SD) of 3.1 (1.6) years. The mean duration of the initial TCZ course was 1.9 (1.1) years. The Kaplan-Meier (KM)-estimated relapse rate at 18 months on TCZ was 15.5%. The first TCZ course was discontinued due to satisfactory remission achievement in 45 (69.2%) patients and adverse events in 6 (9.2%) patients. KM-estimated relapse rate at 18 months after TCZ discontinuation was 47.3%. Compared with patients stopping TCZ at or before 12 months of treatment, the multivariable adjusted HR (95% CI) for relapse in patients on TCZ beyond 12 months was 0.01 (0.00 to 0.28; p=0.005). Thirteen patients received >1 TCZ course. Multivariable adjusted annualised relapse rates (95% CI) in all periods on and off TCZ aggregated were 0.1 (0.1 to 0.2) and 0.4 (0.3 to 0.7), respectively (p=0.0004). Prednisone was discontinued in 76.9% of patients. During the study, 13 serious adverse events occurred in 11 (16.9%) patients.ConclusionLong-term TCZ treatment was associated with remission maintenance in most patients with GCA. The estimated relapse rate by 18 months after TCZ discontinuation was 47.3%.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outcomes during and after long-term tocilizumab treatment in patients with giant cell arteritis

Matza

Dagincourt²,

Mohan³

et al. 2023

RMD Open

View full text Add to dashboard Cite

show abstract

“…To the Editor: Rituximab (RTX) is a monoclonal antibody often used in patient treatment of malignancies and several rheumatological disorders, including vasculitides. [1][2][3] It has become an essential component of many treatment protocols; however, is commonly associated with hypersensitivity infusion reactions. 1 These reactions can involve flushing, fever, pruritis, chills, bronchospasms, nausea, vomiting, and/or urticaria, and can create additional challenges for both the patient and the healthcare team.…”

mentioning

confidence: 99%

Montelukast as a Rescue and Premedication for Rituximab Infusion Reactions

Amatto,

Yacyshyn

2024

J Rheumatol

View full text Add to dashboard Cite

show abstract

“…Nevertheless, some publications recommend adjunctive therapy with tocilizumab as a first-line glucocorticoid-sparing agent for patients with a) new-onset GCA and increased risk for glucocorticoid-related adverse effects or complications, relapse, or prolonged therapy, or b) refractory or relapsing disease (3,5). Other recommendations, such as the recently published Pan American League of Associations for Rheumatology Guidelines, go even further and conditionally recommend that patients with newly diagnosed GCA receive treatment with glucocorticoids and tocilizumab over glucocorticoids alone (8). However, our assessment published in 2020 still stands, which states that it remains to be demonstrated which subgroups of GCA patients would benefit most from tocilizumab treatment in terms of reduced glucocorticoid toxicity, cost-effectiveness, and effect on treatment duration (3).…”

mentioning

confidence: 99%