title: Efficacy of tocilizumab in refractory giant cell arteritis.
abstract: Giant cell arteritis is the most frequent form of vasculitis characterized by a high risk of vascular thrombosis. Major complications are blindness and other vascular ischemia but bowel ischemic involvement is rare. Treatment is based on long-term steroid therapy with numerous side effects. The efficacy of immunosuppressive drugs like azathioprine methotrexate or anti-tumor necrosis factor antibodies appears to be too low to reduce the use of steroids. Th17 lymphocytes and interleukin-6 play an important role in pathogenesis of giant cell arteritis. We report here a case of effective interleukin-6 blocker in the treatment of refractory giant cell arteritis with ileitis and high-dose steroid dependence despite 2 years of treatment with steroids and methotrexate. After infusions of tocilizumab, no relapse at 6 months was found despite the decrease in corticosteroids.
authors.affiliation: Service de médecine interne et maladies systémiques, hôpital Général, University Hospital of Dijon, 3, rue Faubourg-Raines, 21033 Dijon cedex, France. julien.vinit@chu-dijon.fr
authors.forename: Julien
authors.initials: J
authors.lastname: Vinit
authors.forename: Philip
authors.initials: P
authors.lastname: Bielefeld
authors.forename: Géraldine
authors.initials: G
authors.lastname: Muller
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Besancenot
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D013700:Giant Cell Arteritis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008875:Middle Aged; D055502:Secondary Prevention; D000093242:Interleukin-6 Inhibitors; D015850:Interleukin-6
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D000093242:Interleukin-6 Inhibitors; C508600:IL6 protein, human; D015850:Interleukin-6; C502936:tocilizumab