Tocilizumab Vs Methotrexate in a Cohort of Patients Affected by Active GCA: A Comparative Clinical and Ultrasonographic Study
Silvia Grazzini,1,* Edoardo Conticini,1,* Paolo Falsetti,1 Miriana D’Alessandro,2 Jurgen Sota,1 Riccardo Terribili,1 Caterina Baldi,1 Claudia Fabiani,3 Elena Bargagli,2 Luca Cantarini,1 Bruno Frediani1 1Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University...
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Autor*in: |
Grazzini S [verfasserIn] Conticini E [verfasserIn] Falsetti P [verfasserIn] D'Alessandro M [verfasserIn] Sota J [verfasserIn] Terribili R [verfasserIn] Baldi C [verfasserIn] Fabiani C [verfasserIn] Bargagli E [verfasserIn] Cantarini L [verfasserIn] Frediani B [verfasserIn] |
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Englisch |
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2023 |
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In: Biologics: Targets & Therapy - Dove Medical Press, 2009, (2023), Seite 151-160 |
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Übergeordnetes Werk: |
year:2023 ; pages:151-160 |
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DOAJ100182542 |
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520 | |a Silvia Grazzini,1,* Edoardo Conticini,1,* Paolo Falsetti,1 Miriana D’Alessandro,2 Jurgen Sota,1 Riccardo Terribili,1 Caterina Baldi,1 Claudia Fabiani,3 Elena Bargagli,2 Luca Cantarini,1 Bruno Frediani1 1Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 2Respiratory Diseases and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 3Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy*These authors contributed equally to this workCorrespondence: Edoardo Conticini, Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, AOUS Le Scotte, viale Mario Bracci 14, Siena, 53100, Italy, Email conticini.edoardogmail.comIntroduction: No head-to-head study has assessed the superiority of tocilizumab versus methotrexate in giant cell arteritis (GCA), and few studies have demonstrated its effectiveness in terms of ultrasonographic findings, but without a control group. The primary endpoint was to assess whether tocilizumab was superior to methotrexate in inducing normalization of US findings, whereas the secondary endpoint was to assess the effectiveness of precocious withdrawal of glucocorticoids.Methods: We prospectively enrolled all the patients with active GCA at our clinic. The inclusion criteria were clinical diagnosis of GCA; active disease; and clinical, laboratory, and US data, evaluated using the halo count (HC) and OMERACT GCA Ultrasonography Score (OGUS). Evaluations were repeated at 3, 6, and 12 months.Results: Twenty patients were treated with Tocilizumab and 9 with Methotrexate. All but three tocilizumab-treated patients achieved remission at six months, whereas at 12 months, all patients were in glucocorticoid-free remission. Up to three of the nine methotrexate patients experienced a lack of efficacy or minor relapses. Tocilizumab-treated patients showed a statistically significant difference between baseline and all follow-ups in terms of OGUS and HC, whereas the difference in the Methotrexate group was significant after 1 year. The mean glucocorticoid dosage significantly decreased in both groups. No severe adverse events or major relapses were reported.Conclusion: Our study demonstrates the superiority in terms of rapidity of a tocilizumab-based scheme over a methotrexate-based scheme in inducing clinical and US remission. Precocious withdrawal of glucocorticoids did not increase the risk of relapse.Keywords: GCA, giant cell arteritis, methotrexate, tocilizumab, ultrasonography, vasculitis | ||
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(DE-627)DOAJ100182542 (DE-599)DOAJ1a37baf33872429ea3414cdc465df3e7 DE-627 ger DE-627 rakwb eng R5-920 Grazzini S verfasserin aut Tocilizumab Vs Methotrexate in a Cohort of Patients Affected by Active GCA: A Comparative Clinical and Ultrasonographic Study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Silvia Grazzini,1,* Edoardo Conticini,1,* Paolo Falsetti,1 Miriana D’Alessandro,2 Jurgen Sota,1 Riccardo Terribili,1 Caterina Baldi,1 Claudia Fabiani,3 Elena Bargagli,2 Luca Cantarini,1 Bruno Frediani1 1Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 2Respiratory Diseases and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 3Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy*These authors contributed equally to this workCorrespondence: Edoardo Conticini, Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, AOUS Le Scotte, viale Mario Bracci 14, Siena, 53100, Italy, Email conticini.edoardogmail.comIntroduction: No head-to-head study has assessed the superiority of tocilizumab versus methotrexate in giant cell arteritis (GCA), and few studies have demonstrated its effectiveness in terms of ultrasonographic findings, but without a control group. The primary endpoint was to assess whether tocilizumab was superior to methotrexate in inducing normalization of US findings, whereas the secondary endpoint was to assess the effectiveness of precocious withdrawal of glucocorticoids.Methods: We prospectively enrolled all the patients with active GCA at our clinic. The inclusion criteria were clinical diagnosis of GCA; active disease; and clinical, laboratory, and US data, evaluated using the halo count (HC) and OMERACT GCA Ultrasonography Score (OGUS). Evaluations were repeated at 3, 6, and 12 months.Results: Twenty patients were treated with Tocilizumab and 9 with Methotrexate. All but three tocilizumab-treated patients achieved remission at six months, whereas at 12 months, all patients were in glucocorticoid-free remission. Up to three of the nine methotrexate patients experienced a lack of efficacy or minor relapses. Tocilizumab-treated patients showed a statistically significant difference between baseline and all follow-ups in terms of OGUS and HC, whereas the difference in the Methotrexate group was significant after 1 year. The mean glucocorticoid dosage significantly decreased in both groups. No severe adverse events or major relapses were reported.Conclusion: Our study demonstrates the superiority in terms of rapidity of a tocilizumab-based scheme over a methotrexate-based scheme in inducing clinical and US remission. Precocious withdrawal of glucocorticoids did not increase the risk of relapse.Keywords: GCA, giant cell arteritis, methotrexate, tocilizumab, ultrasonography, vasculitis gca giant cell arteritis methotrexate tocilizumab ultraonography vasculitis. Medicine (General) Conticini E verfasserin aut Falsetti P verfasserin aut D'Alessandro M verfasserin aut Sota J verfasserin aut Terribili R verfasserin aut Baldi C verfasserin aut Fabiani C verfasserin aut Bargagli E verfasserin aut Cantarini L verfasserin aut Frediani B verfasserin aut In Biologics: Targets & Therapy Dove Medical Press, 2009 (2023), Seite 151-160 (DE-627)560177038 (DE-600)2415708-9 11775491 nnns year:2023 pages:151-160 https://doaj.org/article/1a37baf33872429ea3414cdc465df3e7 kostenfrei https://www.dovepress.com/tocilizumab-vs-methotrexate-in-a-cohort-of-patients-affected-by-active-peer-reviewed-fulltext-article-BTT kostenfrei https://doaj.org/toc/1177-5491 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2023 151-160 |
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(DE-627)DOAJ100182542 (DE-599)DOAJ1a37baf33872429ea3414cdc465df3e7 DE-627 ger DE-627 rakwb eng R5-920 Grazzini S verfasserin aut Tocilizumab Vs Methotrexate in a Cohort of Patients Affected by Active GCA: A Comparative Clinical and Ultrasonographic Study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Silvia Grazzini,1,* Edoardo Conticini,1,* Paolo Falsetti,1 Miriana D’Alessandro,2 Jurgen Sota,1 Riccardo Terribili,1 Caterina Baldi,1 Claudia Fabiani,3 Elena Bargagli,2 Luca Cantarini,1 Bruno Frediani1 1Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 2Respiratory Diseases and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 3Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy*These authors contributed equally to this workCorrespondence: Edoardo Conticini, Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, AOUS Le Scotte, viale Mario Bracci 14, Siena, 53100, Italy, Email conticini.edoardogmail.comIntroduction: No head-to-head study has assessed the superiority of tocilizumab versus methotrexate in giant cell arteritis (GCA), and few studies have demonstrated its effectiveness in terms of ultrasonographic findings, but without a control group. The primary endpoint was to assess whether tocilizumab was superior to methotrexate in inducing normalization of US findings, whereas the secondary endpoint was to assess the effectiveness of precocious withdrawal of glucocorticoids.Methods: We prospectively enrolled all the patients with active GCA at our clinic. The inclusion criteria were clinical diagnosis of GCA; active disease; and clinical, laboratory, and US data, evaluated using the halo count (HC) and OMERACT GCA Ultrasonography Score (OGUS). Evaluations were repeated at 3, 6, and 12 months.Results: Twenty patients were treated with Tocilizumab and 9 with Methotrexate. All but three tocilizumab-treated patients achieved remission at six months, whereas at 12 months, all patients were in glucocorticoid-free remission. Up to three of the nine methotrexate patients experienced a lack of efficacy or minor relapses. Tocilizumab-treated patients showed a statistically significant difference between baseline and all follow-ups in terms of OGUS and HC, whereas the difference in the Methotrexate group was significant after 1 year. The mean glucocorticoid dosage significantly decreased in both groups. No severe adverse events or major relapses were reported.Conclusion: Our study demonstrates the superiority in terms of rapidity of a tocilizumab-based scheme over a methotrexate-based scheme in inducing clinical and US remission. Precocious withdrawal of glucocorticoids did not increase the risk of relapse.Keywords: GCA, giant cell arteritis, methotrexate, tocilizumab, ultrasonography, vasculitis gca giant cell arteritis methotrexate tocilizumab ultraonography vasculitis. Medicine (General) Conticini E verfasserin aut Falsetti P verfasserin aut D'Alessandro M verfasserin aut Sota J verfasserin aut Terribili R verfasserin aut Baldi C verfasserin aut Fabiani C verfasserin aut Bargagli E verfasserin aut Cantarini L verfasserin aut Frediani B verfasserin aut In Biologics: Targets & Therapy Dove Medical Press, 2009 (2023), Seite 151-160 (DE-627)560177038 (DE-600)2415708-9 11775491 nnns year:2023 pages:151-160 https://doaj.org/article/1a37baf33872429ea3414cdc465df3e7 kostenfrei https://www.dovepress.com/tocilizumab-vs-methotrexate-in-a-cohort-of-patients-affected-by-active-peer-reviewed-fulltext-article-BTT kostenfrei https://doaj.org/toc/1177-5491 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2023 151-160 |
allfields_unstemmed |
(DE-627)DOAJ100182542 (DE-599)DOAJ1a37baf33872429ea3414cdc465df3e7 DE-627 ger DE-627 rakwb eng R5-920 Grazzini S verfasserin aut Tocilizumab Vs Methotrexate in a Cohort of Patients Affected by Active GCA: A Comparative Clinical and Ultrasonographic Study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Silvia Grazzini,1,* Edoardo Conticini,1,* Paolo Falsetti,1 Miriana D’Alessandro,2 Jurgen Sota,1 Riccardo Terribili,1 Caterina Baldi,1 Claudia Fabiani,3 Elena Bargagli,2 Luca Cantarini,1 Bruno Frediani1 1Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 2Respiratory Diseases and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 3Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy*These authors contributed equally to this workCorrespondence: Edoardo Conticini, Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, AOUS Le Scotte, viale Mario Bracci 14, Siena, 53100, Italy, Email conticini.edoardogmail.comIntroduction: No head-to-head study has assessed the superiority of tocilizumab versus methotrexate in giant cell arteritis (GCA), and few studies have demonstrated its effectiveness in terms of ultrasonographic findings, but without a control group. The primary endpoint was to assess whether tocilizumab was superior to methotrexate in inducing normalization of US findings, whereas the secondary endpoint was to assess the effectiveness of precocious withdrawal of glucocorticoids.Methods: We prospectively enrolled all the patients with active GCA at our clinic. The inclusion criteria were clinical diagnosis of GCA; active disease; and clinical, laboratory, and US data, evaluated using the halo count (HC) and OMERACT GCA Ultrasonography Score (OGUS). Evaluations were repeated at 3, 6, and 12 months.Results: Twenty patients were treated with Tocilizumab and 9 with Methotrexate. All but three tocilizumab-treated patients achieved remission at six months, whereas at 12 months, all patients were in glucocorticoid-free remission. Up to three of the nine methotrexate patients experienced a lack of efficacy or minor relapses. Tocilizumab-treated patients showed a statistically significant difference between baseline and all follow-ups in terms of OGUS and HC, whereas the difference in the Methotrexate group was significant after 1 year. The mean glucocorticoid dosage significantly decreased in both groups. No severe adverse events or major relapses were reported.Conclusion: Our study demonstrates the superiority in terms of rapidity of a tocilizumab-based scheme over a methotrexate-based scheme in inducing clinical and US remission. Precocious withdrawal of glucocorticoids did not increase the risk of relapse.Keywords: GCA, giant cell arteritis, methotrexate, tocilizumab, ultrasonography, vasculitis gca giant cell arteritis methotrexate tocilizumab ultraonography vasculitis. Medicine (General) Conticini E verfasserin aut Falsetti P verfasserin aut D'Alessandro M verfasserin aut Sota J verfasserin aut Terribili R verfasserin aut Baldi C verfasserin aut Fabiani C verfasserin aut Bargagli E verfasserin aut Cantarini L verfasserin aut Frediani B verfasserin aut In Biologics: Targets & Therapy Dove Medical Press, 2009 (2023), Seite 151-160 (DE-627)560177038 (DE-600)2415708-9 11775491 nnns year:2023 pages:151-160 https://doaj.org/article/1a37baf33872429ea3414cdc465df3e7 kostenfrei https://www.dovepress.com/tocilizumab-vs-methotrexate-in-a-cohort-of-patients-affected-by-active-peer-reviewed-fulltext-article-BTT kostenfrei https://doaj.org/toc/1177-5491 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2023 151-160 |
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(DE-627)DOAJ100182542 (DE-599)DOAJ1a37baf33872429ea3414cdc465df3e7 DE-627 ger DE-627 rakwb eng R5-920 Grazzini S verfasserin aut Tocilizumab Vs Methotrexate in a Cohort of Patients Affected by Active GCA: A Comparative Clinical and Ultrasonographic Study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Silvia Grazzini,1,* Edoardo Conticini,1,* Paolo Falsetti,1 Miriana D’Alessandro,2 Jurgen Sota,1 Riccardo Terribili,1 Caterina Baldi,1 Claudia Fabiani,3 Elena Bargagli,2 Luca Cantarini,1 Bruno Frediani1 1Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 2Respiratory Diseases and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 3Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy*These authors contributed equally to this workCorrespondence: Edoardo Conticini, Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, AOUS Le Scotte, viale Mario Bracci 14, Siena, 53100, Italy, Email conticini.edoardogmail.comIntroduction: No head-to-head study has assessed the superiority of tocilizumab versus methotrexate in giant cell arteritis (GCA), and few studies have demonstrated its effectiveness in terms of ultrasonographic findings, but without a control group. The primary endpoint was to assess whether tocilizumab was superior to methotrexate in inducing normalization of US findings, whereas the secondary endpoint was to assess the effectiveness of precocious withdrawal of glucocorticoids.Methods: We prospectively enrolled all the patients with active GCA at our clinic. The inclusion criteria were clinical diagnosis of GCA; active disease; and clinical, laboratory, and US data, evaluated using the halo count (HC) and OMERACT GCA Ultrasonography Score (OGUS). Evaluations were repeated at 3, 6, and 12 months.Results: Twenty patients were treated with Tocilizumab and 9 with Methotrexate. All but three tocilizumab-treated patients achieved remission at six months, whereas at 12 months, all patients were in glucocorticoid-free remission. Up to three of the nine methotrexate patients experienced a lack of efficacy or minor relapses. Tocilizumab-treated patients showed a statistically significant difference between baseline and all follow-ups in terms of OGUS and HC, whereas the difference in the Methotrexate group was significant after 1 year. The mean glucocorticoid dosage significantly decreased in both groups. No severe adverse events or major relapses were reported.Conclusion: Our study demonstrates the superiority in terms of rapidity of a tocilizumab-based scheme over a methotrexate-based scheme in inducing clinical and US remission. Precocious withdrawal of glucocorticoids did not increase the risk of relapse.Keywords: GCA, giant cell arteritis, methotrexate, tocilizumab, ultrasonography, vasculitis gca giant cell arteritis methotrexate tocilizumab ultraonography vasculitis. Medicine (General) Conticini E verfasserin aut Falsetti P verfasserin aut D'Alessandro M verfasserin aut Sota J verfasserin aut Terribili R verfasserin aut Baldi C verfasserin aut Fabiani C verfasserin aut Bargagli E verfasserin aut Cantarini L verfasserin aut Frediani B verfasserin aut In Biologics: Targets & Therapy Dove Medical Press, 2009 (2023), Seite 151-160 (DE-627)560177038 (DE-600)2415708-9 11775491 nnns year:2023 pages:151-160 https://doaj.org/article/1a37baf33872429ea3414cdc465df3e7 kostenfrei https://www.dovepress.com/tocilizumab-vs-methotrexate-in-a-cohort-of-patients-affected-by-active-peer-reviewed-fulltext-article-BTT kostenfrei https://doaj.org/toc/1177-5491 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2023 151-160 |
allfieldsSound |
(DE-627)DOAJ100182542 (DE-599)DOAJ1a37baf33872429ea3414cdc465df3e7 DE-627 ger DE-627 rakwb eng R5-920 Grazzini S verfasserin aut Tocilizumab Vs Methotrexate in a Cohort of Patients Affected by Active GCA: A Comparative Clinical and Ultrasonographic Study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Silvia Grazzini,1,* Edoardo Conticini,1,* Paolo Falsetti,1 Miriana D’Alessandro,2 Jurgen Sota,1 Riccardo Terribili,1 Caterina Baldi,1 Claudia Fabiani,3 Elena Bargagli,2 Luca Cantarini,1 Bruno Frediani1 1Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 2Respiratory Diseases and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 3Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy*These authors contributed equally to this workCorrespondence: Edoardo Conticini, Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, AOUS Le Scotte, viale Mario Bracci 14, Siena, 53100, Italy, Email conticini.edoardogmail.comIntroduction: No head-to-head study has assessed the superiority of tocilizumab versus methotrexate in giant cell arteritis (GCA), and few studies have demonstrated its effectiveness in terms of ultrasonographic findings, but without a control group. The primary endpoint was to assess whether tocilizumab was superior to methotrexate in inducing normalization of US findings, whereas the secondary endpoint was to assess the effectiveness of precocious withdrawal of glucocorticoids.Methods: We prospectively enrolled all the patients with active GCA at our clinic. The inclusion criteria were clinical diagnosis of GCA; active disease; and clinical, laboratory, and US data, evaluated using the halo count (HC) and OMERACT GCA Ultrasonography Score (OGUS). Evaluations were repeated at 3, 6, and 12 months.Results: Twenty patients were treated with Tocilizumab and 9 with Methotrexate. All but three tocilizumab-treated patients achieved remission at six months, whereas at 12 months, all patients were in glucocorticoid-free remission. Up to three of the nine methotrexate patients experienced a lack of efficacy or minor relapses. Tocilizumab-treated patients showed a statistically significant difference between baseline and all follow-ups in terms of OGUS and HC, whereas the difference in the Methotrexate group was significant after 1 year. The mean glucocorticoid dosage significantly decreased in both groups. No severe adverse events or major relapses were reported.Conclusion: Our study demonstrates the superiority in terms of rapidity of a tocilizumab-based scheme over a methotrexate-based scheme in inducing clinical and US remission. Precocious withdrawal of glucocorticoids did not increase the risk of relapse.Keywords: GCA, giant cell arteritis, methotrexate, tocilizumab, ultrasonography, vasculitis gca giant cell arteritis methotrexate tocilizumab ultraonography vasculitis. Medicine (General) Conticini E verfasserin aut Falsetti P verfasserin aut D'Alessandro M verfasserin aut Sota J verfasserin aut Terribili R verfasserin aut Baldi C verfasserin aut Fabiani C verfasserin aut Bargagli E verfasserin aut Cantarini L verfasserin aut Frediani B verfasserin aut In Biologics: Targets & Therapy Dove Medical Press, 2009 (2023), Seite 151-160 (DE-627)560177038 (DE-600)2415708-9 11775491 nnns year:2023 pages:151-160 https://doaj.org/article/1a37baf33872429ea3414cdc465df3e7 kostenfrei https://www.dovepress.com/tocilizumab-vs-methotrexate-in-a-cohort-of-patients-affected-by-active-peer-reviewed-fulltext-article-BTT kostenfrei https://doaj.org/toc/1177-5491 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2023 151-160 |
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R5-920 Tocilizumab Vs Methotrexate in a Cohort of Patients Affected by Active GCA: A Comparative Clinical and Ultrasonographic Study gca giant cell arteritis methotrexate tocilizumab ultraonography vasculitis |
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Tocilizumab Vs Methotrexate in a Cohort of Patients Affected by Active GCA: A Comparative Clinical and Ultrasonographic Study |
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Grazzini S Conticini E Falsetti P D'Alessandro M Sota J Terribili R Baldi C Fabiani C Bargagli E Cantarini L Frediani B |
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Tocilizumab Vs Methotrexate in a Cohort of Patients Affected by Active GCA: A Comparative Clinical and Ultrasonographic Study |
abstract |
Silvia Grazzini,1,* Edoardo Conticini,1,* Paolo Falsetti,1 Miriana D’Alessandro,2 Jurgen Sota,1 Riccardo Terribili,1 Caterina Baldi,1 Claudia Fabiani,3 Elena Bargagli,2 Luca Cantarini,1 Bruno Frediani1 1Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 2Respiratory Diseases and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 3Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy*These authors contributed equally to this workCorrespondence: Edoardo Conticini, Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, AOUS Le Scotte, viale Mario Bracci 14, Siena, 53100, Italy, Email conticini.edoardogmail.comIntroduction: No head-to-head study has assessed the superiority of tocilizumab versus methotrexate in giant cell arteritis (GCA), and few studies have demonstrated its effectiveness in terms of ultrasonographic findings, but without a control group. The primary endpoint was to assess whether tocilizumab was superior to methotrexate in inducing normalization of US findings, whereas the secondary endpoint was to assess the effectiveness of precocious withdrawal of glucocorticoids.Methods: We prospectively enrolled all the patients with active GCA at our clinic. The inclusion criteria were clinical diagnosis of GCA; active disease; and clinical, laboratory, and US data, evaluated using the halo count (HC) and OMERACT GCA Ultrasonography Score (OGUS). Evaluations were repeated at 3, 6, and 12 months.Results: Twenty patients were treated with Tocilizumab and 9 with Methotrexate. All but three tocilizumab-treated patients achieved remission at six months, whereas at 12 months, all patients were in glucocorticoid-free remission. Up to three of the nine methotrexate patients experienced a lack of efficacy or minor relapses. Tocilizumab-treated patients showed a statistically significant difference between baseline and all follow-ups in terms of OGUS and HC, whereas the difference in the Methotrexate group was significant after 1 year. The mean glucocorticoid dosage significantly decreased in both groups. No severe adverse events or major relapses were reported.Conclusion: Our study demonstrates the superiority in terms of rapidity of a tocilizumab-based scheme over a methotrexate-based scheme in inducing clinical and US remission. Precocious withdrawal of glucocorticoids did not increase the risk of relapse.Keywords: GCA, giant cell arteritis, methotrexate, tocilizumab, ultrasonography, vasculitis |
abstractGer |
Silvia Grazzini,1,* Edoardo Conticini,1,* Paolo Falsetti,1 Miriana D’Alessandro,2 Jurgen Sota,1 Riccardo Terribili,1 Caterina Baldi,1 Claudia Fabiani,3 Elena Bargagli,2 Luca Cantarini,1 Bruno Frediani1 1Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 2Respiratory Diseases and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 3Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy*These authors contributed equally to this workCorrespondence: Edoardo Conticini, Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, AOUS Le Scotte, viale Mario Bracci 14, Siena, 53100, Italy, Email conticini.edoardogmail.comIntroduction: No head-to-head study has assessed the superiority of tocilizumab versus methotrexate in giant cell arteritis (GCA), and few studies have demonstrated its effectiveness in terms of ultrasonographic findings, but without a control group. The primary endpoint was to assess whether tocilizumab was superior to methotrexate in inducing normalization of US findings, whereas the secondary endpoint was to assess the effectiveness of precocious withdrawal of glucocorticoids.Methods: We prospectively enrolled all the patients with active GCA at our clinic. The inclusion criteria were clinical diagnosis of GCA; active disease; and clinical, laboratory, and US data, evaluated using the halo count (HC) and OMERACT GCA Ultrasonography Score (OGUS). Evaluations were repeated at 3, 6, and 12 months.Results: Twenty patients were treated with Tocilizumab and 9 with Methotrexate. All but three tocilizumab-treated patients achieved remission at six months, whereas at 12 months, all patients were in glucocorticoid-free remission. Up to three of the nine methotrexate patients experienced a lack of efficacy or minor relapses. Tocilizumab-treated patients showed a statistically significant difference between baseline and all follow-ups in terms of OGUS and HC, whereas the difference in the Methotrexate group was significant after 1 year. The mean glucocorticoid dosage significantly decreased in both groups. No severe adverse events or major relapses were reported.Conclusion: Our study demonstrates the superiority in terms of rapidity of a tocilizumab-based scheme over a methotrexate-based scheme in inducing clinical and US remission. Precocious withdrawal of glucocorticoids did not increase the risk of relapse.Keywords: GCA, giant cell arteritis, methotrexate, tocilizumab, ultrasonography, vasculitis |
abstract_unstemmed |
Silvia Grazzini,1,* Edoardo Conticini,1,* Paolo Falsetti,1 Miriana D’Alessandro,2 Jurgen Sota,1 Riccardo Terribili,1 Caterina Baldi,1 Claudia Fabiani,3 Elena Bargagli,2 Luca Cantarini,1 Bruno Frediani1 1Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 2Respiratory Diseases and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; 3Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy*These authors contributed equally to this workCorrespondence: Edoardo Conticini, Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, AOUS Le Scotte, viale Mario Bracci 14, Siena, 53100, Italy, Email conticini.edoardogmail.comIntroduction: No head-to-head study has assessed the superiority of tocilizumab versus methotrexate in giant cell arteritis (GCA), and few studies have demonstrated its effectiveness in terms of ultrasonographic findings, but without a control group. The primary endpoint was to assess whether tocilizumab was superior to methotrexate in inducing normalization of US findings, whereas the secondary endpoint was to assess the effectiveness of precocious withdrawal of glucocorticoids.Methods: We prospectively enrolled all the patients with active GCA at our clinic. The inclusion criteria were clinical diagnosis of GCA; active disease; and clinical, laboratory, and US data, evaluated using the halo count (HC) and OMERACT GCA Ultrasonography Score (OGUS). Evaluations were repeated at 3, 6, and 12 months.Results: Twenty patients were treated with Tocilizumab and 9 with Methotrexate. All but three tocilizumab-treated patients achieved remission at six months, whereas at 12 months, all patients were in glucocorticoid-free remission. Up to three of the nine methotrexate patients experienced a lack of efficacy or minor relapses. Tocilizumab-treated patients showed a statistically significant difference between baseline and all follow-ups in terms of OGUS and HC, whereas the difference in the Methotrexate group was significant after 1 year. The mean glucocorticoid dosage significantly decreased in both groups. No severe adverse events or major relapses were reported.Conclusion: Our study demonstrates the superiority in terms of rapidity of a tocilizumab-based scheme over a methotrexate-based scheme in inducing clinical and US remission. Precocious withdrawal of glucocorticoids did not increase the risk of relapse.Keywords: GCA, giant cell arteritis, methotrexate, tocilizumab, ultrasonography, vasculitis |
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