Tocilizumab Might Lessen Need for High-Dose Prednisone in Patients with Giant-Cell Arteritis

Patients with giant-cell arteritis (GCA) generally are treated with high-dose steroids; once such treatment is started, tapering is difficult due to flares. Patients also often experience adverse effects from steroids. Steroid-sparing therapies include methotrexate, azathioprine, and hydroxychloroquine, but none of these are uniformly effective.

In this 1-year, industry-sponsored, international study, 251 patients with GCA were randomized to receive subcutaneous tocilizumab (Actemra; weekly or every 2 weeks [biweekly]) or placebo. Tocilizumab patients tapered their steroid doses over 26 weeks. Placebo patients tapered their steroid doses over either 26 or 52 weeks.

Sustained remission at 52 weeks occurred in 56% of the weekly tocilizumab grou…