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Tocilizumab in visual involvement of giant cell arteritis: a multicenter study of 471 patients.
Loricera, Javier; Castañeda, Santos; Moriano, Clara; Narváez, Javier; Aldasoro, Vicente; Maiz, Olga; Melero, Rafael; Villa, Ignacio; Vela, Paloma; Romero-Yuste, Susana; Callejas, José L; de Miguel, Eugenio; Galíndez-Agirregoikoa, Eva; Sivera, Francisca; Fernández-López, Jesús C; Galisteo, Carles; Ferraz-Amaro, Iván; Sánchez-Martín, Julio; Sánchez-Bilbao, Lara; Calderón-Goercke, Mónica; Casado, Alfonso; Hernández, José L; González-Gay, Miguel A; Blanco, Ricardo.
Afiliación
  • Loricera J; Rheumatology Division, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain.
  • Castañeda S; Department of Rheumatology, Hospital Universitario de La Princesa, IIS-Princesa, Catedra UAM-Roche, EPID-Future, UAM, Madrid, Spain.
  • Moriano C; Department of Rheumatology, Complejo Asistencial Universitario de León, León, Spain.
  • Narváez J; Department of Rheumatology, Hospital de Bellvitge, Barcelona, Spain.
  • Aldasoro V; Department of Rheumatology, Complejo Hospitalario de Navarra, Pamplona, Spain.
  • Maiz O; Department of Rheumatology, Hospital Universitario de Donostia, San Sebastián, Spain.
  • Melero R; Department of Rheumatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
  • Villa I; Department of Rheumatology, Hospital Sierrallana, Torrelavega, Spain.
  • Vela P; Department of Rheumatology, Hospital General Universitario de Alicante, Alicante, Spain.
  • Romero-Yuste S; Department of Rheumatology, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain.
  • Callejas JL; Unit of Systemic Autoimmune Diseases, Hospital San Cecilio, Granada, Spain.
  • de Miguel E; Department of Rheumatology, Hospital La Paz, Madrid, Spain.
  • Galíndez-Agirregoikoa E; Department of Rheumatology, Hospital de Basurto, Bilbao, Spain.
  • Sivera F; Department of Rheumatology, Hospital Universitario de Elda, Alicante, Spain.
  • Fernández-López JC; Department of Rheumatology, Hospital Universitario Juan Canalejo, A Coruña, Spain.
  • Galisteo C; Department of Rheumatology, Hospital Parc Taulí, Barcelona, Spain.
  • Ferraz-Amaro I; Department of Rheumatology, Complejo Hospitalario Universitario de Canarias, Tenerife, Spain.
  • Sánchez-Martín J; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain.
  • Sánchez-Bilbao L; Rheumatology Division, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain.
  • Calderón-Goercke M; Rheumatology Division, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain.
  • Casado A; Department of Ophthalmology, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain.
  • Hernández JL; Internal Medicine Division, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla s/n, ES-39008 Santander, Spain.
  • González-Gay MA; Rheumatology Division, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla (IDIVAL), Avda. Valdecilla s/n, ES-39008 Santander, Spain.
  • Blanco R; Rheumatology Division, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla (IDIVAL), Avda. Valdecilla s/n, ES-39008 Santander, Spain.
Ther Adv Musculoskelet Dis ; 14: 1759720X221113747, 2022.
Article en En | MEDLINE | ID: mdl-35898567
Background: 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. Objective: 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. Design: This is an observational multicenter study of patients with GCA treated with TCZ. Methods: 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. Results: Four hundred seventy-one GCA patients (mean age, 74 ± 9 years) 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. Conclusion: 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials Idioma: En Revista: Ther Adv Musculoskelet Dis Año: 2022 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials Idioma: En Revista: Ther Adv Musculoskelet Dis Año: 2022 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido