OP0064 TOCILIZUMAB IN CRANIAL AND EXTRACRANIAL REFRACTORY GIANT CELL ARTERITIS: A MULTICENTER STUDY OF 312 CASES

Background: Giant cell arteritis (GCA) may be divided into cranial, and extracranial GCA. Tocilizumab (TCZ) has shown efficacy and safety in GCA and other large-vessel vasculitis (LVV) (1-5). Objectives: To compare the efficacy of TCZ in cranial and extracranial GCA. Methods: Multicenter observational study of 312 patients with GCA treated with TCZ. They were divided into 3 groups a) only cranial (cGCA), b) only extracranial (ecGCA), c) mixed affection (mixGCA). GCA was diagnosed by a) ACR criteria, and/or b) positive temporal artery biopsy, and/or c) LVV by imaging. Remission and sustained remission was defined according to EULAR definitions (1). In ecGCA and mixGCA we also studied the improvement (complete or partial) by imaging techniques. Results: We studied 312 patients (218 females; mean age, 73.4±9.6 years). TABLE shows the main features of the 3 groups. Remission at month 6 was higher in cGCA, as well as the sustained remission at month12 (FIGURE). At 18 and 24months, were similar in the 3 groups. Improvement by imaging techniques was partial/complete at 6,12,18 and 24 months, in 50%/0%,71%/0%, 61%/15% and 67%/17% respectively, in ecGCA, and in 75%/0%,53%/18%, 64%/12% and 50%/28% in mixGCA. Conclusion: TCZ seems to be effective in all phenotypes but it is faster in cGCA in reaching remission. However, improvement by imaging techniques was partial and very rarely complete in ecGCA and mixGCA. References: [1]Hellmich B, et al. Ann Rheum Dis. 2020; 79: 19-30. [2]Stone JH, et al. N Engl J Med. 2017; 377: 317-28. [3]Calderon-Goercke M, et al. Semin Arthritis Rheum 2019; 49:126-35. https://doi.org/10.1016/j.semarthrit.2019.01.003. [4]Prieto Pena D et al. Clin Exp Rheumatol 2020 Nov 27. PMID: 33253103. [5]Loricera J, et al. Clin Exp Rheumatol 2016; 34:S44-53. PMID: 27050507 Disclosure of Interests: Lara Sanchez-Bilbao: None declared, Javier Loricera: None declared, Vicente Aldasoro: None declared, Juan Pablo Valdivieso-Acha: None declared, Ignacio Villa-Blanco: None declared, Olga Maiz: None declared, Rafael Melero: None declared, Clara Moriano: None declared, Julio Sanchez: None declared, Eugenio de Miguel: None declared, Eva Perez-Pampin: None declared, Juan Ramon De Dios: None declared, Juan Carlos Nieto Gonzalez: None declared, Eva Galindez-Agirregoikoa: None declared, Patricia Moya: None declared, Francisca Sivera: None declared, Jose Luis Andreu Sanchez: None declared, Valvanera Pinillos: None declared, Andrea Garcia-Valle: None declared, Paloma Vela-Casasempere: None declared, Noelia Alvarez-Rivas: None declared, Marcelino Revenga: None declared, Sara Manrique Arija: None declared, Carlos Fernandez-Lopez: None declared, Enrique Raya: None declared, Cristina Hidalgo: None declared, Ruth Lopez-Gonzalez: None declared, Cristina Campos Fernandez: None declared, Antonio Juan-Mas: None declared, Beatriz Arca: None declared, Inigo Rua-Figueroa: None declared, Maria Dolors Boquet: None declared, Antonio Garcia: None declared, Adela Gallego: None declared, Eva Salgado-Perez: None declared, Miguel A Gonzalez-Gay Speakers bureau: Abbvie, Pfizer, Roche, Sanofi, Lilly, Celgene and MSD, Grant/research support from: Abbvie, MSD, Jansen and Roche, Ricardo Blanco Speakers bureau: Abbvie, Lilly, Pfizer, Roche, Bristol-Myers, Janssen, UCB Pharma and MSD, Grant/research support from: Abbvie, MSD and Roche