Efficacy of Tocilizumab in Reducing Steroid Requirements in Giant Cell Arteries (GCA) at a Veterans Hospital
by Andrea Zuloaga, PharmD, Bianca L. Harris, PharmD, Susan Hylland, MD, Shannon K. Hobson, PharmD
"Objective: Giant Cell Arteritis (GCA) is a form of vasculitis involving large and medium-sized arteries, commonly affecting the cranial branches of the carotid arteries with the mainstay of therapy being glucocorticoids. In 2017, the FDA approved tocilizumab as a glucocorticoid-sparing agent for GCA. The purpose of this review was to evaluate the efficacy and safety
of tocilizumab therapy in patients with GCA, and its efficacy in aiding in glucocorticoid de-escalation at a veterans’ hospital.
Methods: A retrospective chart review was performed for patients at the William S. Middleton Memorial Veterans Hospital with prescriptions for tocilizumab for GCA from May 2017 to May 2019.
Results: Laboratory monitoring was appropriate for each patient in accordance with monitoring recommendations, with no instances of significant abnormal changes. Tocilizumab therapy was interrupted in
one patient due to illness and in another due to a planned procedure. Tocilizumab therapy was discontinued in one patient diagnosed with prostate cancer who also showed remission of GCA and in another patient who chose to discontinue therapy after 33 months of therapy. All patients were able to be tapered off glucocorticoids while on tocilizumab.
Conclusions: Tocilizumab dosed weekly and every other week led to glucocorticoid-free remission of GCA at 52 weeks in the available literature. This review showed similar results, with the majority of patients having been glucocorticoid-free after approximately 15 months of treatment with tocilizumab."
Keywords: Glucocorticoids, tocilizumab, Giant Cell Arteritis, Retrospective Studies, Hospitals, Veterans, Laboratories, Antibodies, Monoclonal, Humanized, Carotid Arteries, Prescriptions, Prostatic Neoplasms
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2021 May/June Table of Contents
"Objective: Giant Cell Arteritis (GCA) is a form of vasculitis involving large and medium-sized arteries, commonly affecting the cranial branches of the carotid arteries with the mainstay of therapy being glucocorticoids. In 2017, the FDA approved tocilizumab as a glucocorticoid-sparing agent for GCA. The purpose of this review was to evaluate the efficacy and safety
of tocilizumab therapy in patients with GCA, and its efficacy in aiding in glucocorticoid de-escalation at a veterans’ hospital.
Methods: A retrospective chart review was performed for patients at the William S. Middleton Memorial Veterans Hospital with prescriptions for tocilizumab for GCA from May 2017 to May 2019.
Results: Laboratory monitoring was appropriate for each patient in accordance with monitoring recommendations, with no instances of significant abnormal changes. Tocilizumab therapy was interrupted in
one patient due to illness and in another due to a planned procedure. Tocilizumab therapy was discontinued in one patient diagnosed with prostate cancer who also showed remission of GCA and in another patient who chose to discontinue therapy after 33 months of therapy. All patients were able to be tapered off glucocorticoids while on tocilizumab.
Conclusions: Tocilizumab dosed weekly and every other week led to glucocorticoid-free remission of GCA at 52 weeks in the available literature. This review showed similar results, with the majority of patients having been glucocorticoid-free after approximately 15 months of treatment with tocilizumab."
Keywords: Glucocorticoids, tocilizumab, Giant Cell Arteritis, Retrospective Studies, Hospitals, Veterans, Laboratories, Antibodies, Monoclonal, Humanized, Carotid Arteries, Prescriptions, Prostatic Neoplasms
Download PDF
2021 May/June Table of Contents