From Medscape Prof Jonathan Kay Professor of medicine at the University of Massachusetts Medical School.
Tocilizumab, an interleukin (IL)-6 receptor inhibitor in giant cell arteritis. This study was an efficacy and safety study looking at tocilizumab in patients with documented giant cell arteritis to see whether tocilizumab improved the remission of patients after tapering from glucocorticoid therapy. The patients were studied for 52 weeks, and patients who were at least 50 years of age who had giant cell arteritis confirmed by temporal artery biopsy or cross-sectional imaging with elevation of acute-phase reactants that was attributable to giant cell arteritis were randomly assigned 1:1:2:1 into four groups.
The first group was treated with a short course of prednisone over 26 weeks, which was tapered, and they were given a weekly subcutaneous placebo. The second group received a long course of prednisone tapered over 52 weeks, again, with a weekly subcutaneous placebo. The third group received weekly subcutaneous tocilizumab at the usual dose of 162 mg and a 26-week short-course prednisone taper. The fourth group received an every-other-week dose of tocilizumab subcutaneously at 162 mg and a short-course prednisone taper over 26 weeks. The randomization allowed twice as many patients to be entered into the weekly subcutaneous tocilizumab arm as into the other three arms.