scholarly journals Mycophenolate mofetil as steroid-sparing treatment for elderly patients with giant cell arteritis: report of three cases

2012 ◽  
Vol 24 (3) ◽  
pp. 273-277 ◽  
Author(s):  
Savino Sciascia ◽  
Doloretta Piras ◽  
Simone Baldovino ◽  
Alessandra Russo ◽  
Carla Naretto ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Elderly Patients ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Steroid Sparing

scholarly journals Steroid-Sparing Agents in Giant Cell Arteritis

2019 ◽  
Vol 13 (1) ◽  
pp. 61-71
Author(s):  
Amol Sagdeo ◽  
Ayman Askari ◽  
Josh Dixey ◽  
Hana Morrissey ◽  
Patrick A. Ball
Keyword(s):  
Mycophenolate Mofetil ◽  
Side Effects ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Psychological Effects ◽  
Remission Induction ◽  
Remission Maintenance ◽  
Short And Long Term ◽  
Steroid Sparing

Background: Giant cell arteritis is the commonest form of medium-to-large vessel vasculitis, requiring long-term corticosteroid therapy. The short- and long-term side effects of corticosteroids are many, including weight gain, psychological effects, osteoporosis, cardiometabolic complications, and infections. Materials and Methods: Various agents used in place of or in combination with corticosteroids to reduce corticosteroid-related side effects were reviewed. However, considerable variation in practice was identified giving unclear guidance. This review included the most recent evidence on methotrexate, mycophenolate mofetil, azathioprine, cyclophosphamide, abatacept, and tocilizumab Results and Discussion: Also discussed are encouraging results with tocilizumab in GCA patients. Amongst the agents available for steroid-sparing effects, tocilizumab demonstrated the most robust data and is consequently recommended as the agent of choice for steroid-sparing, for remission induction, remission maintenance, and treating relapsing and refractory cases of GCA.

scholarly journals POS0338 STEROID-SPARING EFFECT OF ANAKINRA IN GIANT-CELL ARTERITIS: A CASE SERIES WITH CLINICAL, BIOLOGICAL AND ICONOGRAPHIC LONG-TERM ASSESSMENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 397.1-397
Author(s):  
S. Deshayes ◽  
K. Ly ◽  
V. Rieu ◽  
G. Maigné ◽  
N. M. Silva ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Interleukin 1 ◽  
Oral Prednisone ◽  
Large Vessel ◽  
Daily Dose ◽  
Sparing Effect ◽  
Steroid Sparing

Background:The treatment of giant cell arteritis (GCA) relies on corticosteroids but is burdened by a high rate of relapses and adverse effects. Anti-interleukin-6 treatments show a clear benefit with a significant steroid-sparing effect, but late relapses occur after treatment discontinuation. In addition to interleukin-6, interleukin-1 also appears to play a significant role in GCA pathophysiology.Objectives:We report herein the efficacy of anakinra, an interleukin-1 receptor antagonist, in 6 GCA patients exhibiting corticosteroid dependence or resistance, specifically analyzing the outcome of aortitis in 4 of them, and including the long-term follow-up of 2 previously described patients (1).Methods:This retrospective study analyzed the cases of all GCA patients treated with anakinra from the French Study Group for Large Vessel Vasculitis.Patients had to satisfy the following two criteria to be enrolled in this retrospective study. First, their diagnosis of GCA should be based on the fulfillment of at least 3 criteria of the American College of Rheumatology (ACR) for GCA or on the satisfaction of 2 of these criteria along with the demonstration of LVI on imaging. Second, patients should have received anakinra because of corticosteroid dependence or resistance.Corticosteroid dependence was defined as ≥2 relapses or the combination of 2 of the following criteria: a daily dose of oral prednisone >20 mg/day (or 0.3 mg/kg) at 6 months; a daily dose of oral prednisone >10 mg/day (or 0.2 mg/kg) at 12 months; and/or a treatment maintained >24 months because of a relapsing disease course. Corticosteroid resistance was defined as persistent increased inflammatory parameters at month 3 despite a steroid dosage over 0.5 mg/kg.Results:After a median duration of anakinra therapy of 19 [18–32] months, all 6 patients exhibited complete clinical and biological remission. Among the 4 patients with large-vessel involvement, 2 had a disappearance of aortitis under anakinra, and 2 showed a decrease in vascular uptake. After a median follow-up of 56 [48–63] months, corticosteroids were discontinued in 4 patients, and corticosteroid dosage could be decreased to 5 mg/day in 2 patients. One patient relapsed 13 months after anakinra introduction in the context of increasing the daily anakinra injection interval to every 48 hours. Three patients experienced transient injection-site reactions, and 1 patient had pneumonia.Figure 1.Steroid dosages before and after the introduction of anakinra in 6 patients with giant-cell arteritis and corticosteroid dependence or resistance. The black arrow indicates the time of anakinra introduction.Conclusion:In this short series, anakinra appears to be an efficient and safe steroid-sparing agent in refractory GCA, with a possible beneficial effect on large-vessel involvement.References:[1]Ly K-H, Stirnemann J, Liozon E, Michel M, Fain O, Fauchais A-L. Interleukin-1 blockade in refractory giant cell arteritis. Joint Bone Spine 2014;81:76–8.Disclosure of Interests:Samuel Deshayes: None declared, Kim LY: None declared, Virginie Rieu: None declared, Gwénola Maigné: None declared, Nicolas Martin Silva: None declared, Alain Manrique: None declared, Jacques Monteil: None declared, Hubert de Boysson Speakers bureau: Roche-Chugai, Grant/research support from: Roche-Chugai, Achille Aouba Grant/research support from: SOBI

scholarly journals Steroid-sparing effect and toxicity of dapsone treatment in giant cell arteritis

Medicine ◽  
2016 ◽  
Vol 95 (42) ◽  
pp. e4974 ◽  
Author(s):  
Kim Heang Ly ◽  
François Dalmay ◽  
Guillaume Gondran ◽  
Sylvain Palat ◽  
Holy Bezanahary ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Sparing Effect ◽  
Steroid Sparing

No additional steroid‐sparing effect of cyclosporine A in giant cell arteritis

2006 ◽  
Vol 35 (4) ◽  
pp. 327-329 ◽  
Author(s):  
C. Schaufelberger ◽  
H. Möllby ◽  
A. Uddhammar ◽  
J. Bratt ◽  
E. Nordborg
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Cyclosporine A ◽  
Sparing Effect ◽  
Steroid Sparing

Steroid sparing drug treatments for giant cell arteritis

2009 ◽  
Author(s):  
Catherine L Hill ◽  
Antonia Cole ◽  
Sue Lester ◽  
Samuel L Whittle
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Drug Treatments ◽  
Steroid Sparing

Giant cell arteritis (Horton's disease) in very elderly patients aged 80 years and older: A study of 25 cases

2015 ◽  
Vol 16 (6) ◽  
pp. 679-685 ◽  
Author(s):  
Géraldine Muller ◽  
Hervé Devilliers ◽  
Jean-François Besancenot ◽  
Patrick Manckoundia
Keyword(s):  
Elderly Patients ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Very Elderly ◽  
Horton’S Disease

scholarly journals Interleukin 6 Blockade as Steroid-sparing Treatment for 2 Patients with Giant Cell Arteritis: Figure 1.

2011 ◽  
Vol 38 (9) ◽  
pp. 2080-2081 ◽  
Author(s):  
SAVINO SCIASCIA ◽  
DANIELA ROSSI ◽  
DARIO ROCCATELLO
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Interleukin 6 ◽  
Steroid Sparing

Tocilizumab in Giant Cell Arteritis: A Real-Life Retrospective Study

Angiology ◽  
2018 ◽  
Vol 69 (9) ◽  
pp. 763-769 ◽  
Author(s):  
Gianfranco Vitiello ◽  
Carolina Orsi Battaglini ◽  
Giulia Carli ◽  
Anna Radice ◽  
Andrea Matucci ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Disease Activity ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
Positron Emission ◽  
Steroid Sparing ◽  
Fluorodeoxyglucose Positron Emission

This study aims to evaluate (1) the efficacy and safety of tocilizumab (TCZ) as a steroid-sparing agent in patients with giant cell arteritis (GCA) and (2) the usefulness of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in the follow-up and to detect disease activity. We retrospectively evaluated 12 patients with GCA treated with TCZ (8 mg/kg/mo). Pre- and posttherapy data about clinical signs and symptoms, laboratory results, FDG-PET imaging study, and the mean glucocorticoid (GC) dose were used to assess disease activity. Tocilizumab achieved complete disease remission in all patients. Mean FDG-PET-detected standard uptake value decreased from 2.05 ± 0.64 to 1.78 ± 0.45 ( P = .005). In 2 patients in whom temporal arteries color Doppler sonography examination was consistent with temporal arteritis, the hypoechoic halo disappeared after TCZ treatment. Mean GC dose was tapered from 26.6 ± 13.4 mg/d to 3.3 ± 3.1 mg/d ( P < .0001). One-half of the patients discontinued GC therapy. Three patients experienced severe adverse reactions and had to stop TCZ therapy. In accordance with previous reports, TCZ is an effective steroid-sparing agent for GCA, although careful monitoring of adverse drug reactions is needed. 18F-fluorodeoxyglucose positron emission tomography could be used to monitor disease activity in TCZ-treated patients, but prospective studies are needed to confirm these data.

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