Subcutaneous Versus Intravenous Tocilizumab in Aortitis Associated With Giant Cell Arteritis: Multicenter Study of 196 Patients
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective Aortitis associated with giant cell arteritis (GCA) is a severe manifestation, potentially leading to aneurysms and aortic dissection. Tocilizumab (TCZ) has demonstrated efficacy in the treatment of GCA, both intravenously or subcutaneously administered. However, pivotal studies did not specifically evaluate aortic involvement, and no comparison of intravenous (IV) versus subcutaneous (SC) TCZ has been performed in patients with GCA‐related aortitis. The objective of this study was to compare the effectiveness of TCZ according to the administration route in patients with GCA‐associated aortitis under clinical practice conditions. Methods This was a multicenter observational study including 196 patients diagnosed with GCA‐associated aortitis by imaging and treated with TCZ. Patients were grouped by administration route: IV or SC. GCA was diagnosed following the 1990 American College of Rheumatology criteria, temporal artery biopsy, and/or vascular imaging. Aortitis was identified using 18 F‐fluorodeoxyglucose positron emission tomography/computed tomography scan. Main outcomes included EULAR remission, clinical and imaging remission, absence of systemic inflammation, and glucocorticoid‐sparing effect. Results Of 196 patients (148 women; mean age 69.8 ± SD 9.4 years), 110 received IV TCZ and 86 SC TCZ. Baseline clinical characteristics and markers of inflammation were comparable between groups. The glucocorticoid‐sparing effect was similar. At 24‐month follow‐up, EULAR‐defined remission was significantly more frequent in the SC group (83.3% vs 80.6%; P < 0.05). However, rates of imaging remission and absence of systemic inflammation were comparable between treatment arms. Conclusions In this real‐world cohort of GCA‐associated aortitis, SC TCZ showed slightly greater effectiveness than IV TCZ in achieving EULAR‐defined remission, whereas no significant differences were observed between both routes regarding imaging remission.
Source: Arthritis Care & Research
DOI: 10.1002/acr.80006
Authors: Carmen Secada‐Gómez, Javier Loricera, Adrián Martín‐Gutiérrez, Javier Narváez, Vicente Aldasoro, Olga Maiz, Paloma Vela, Susana Romero‐Yuste, Eugenio de Miguel, Eva Galíndez‐Agirregoikoa, Jesús C. Fernandez‐López, Iván Ferraz‐Amaro, Julio Sanchez‐Martín, Patricia Moya‐Alvarado, Cristina Campos, Santos Castañeda, Ricardo Blanco, the Tocilizumab in Giant Cell Arteritis Spanish Collaborative Group
Institutions: Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, Bellvitge University Hospital, Complejo Hospitalario de Navarra, Donostiako Unibertsitate Ospitalea, Hospital General Universitario de Alicante Doctor Balmis, Complejo Hospitalario de Pontevedra, Hospital Universitario La Paz, Hospital de Basurto, Hospital Universitario de Canarias, Hospital Universitario 12 De Octubre, Hospital de Sant Pau, Hospital General Universitario De Valencia, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7123517027