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La Revue de médecine interne v.39 no.2, 2018년, pp.78 - 83   SCIE
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Efficacy and tolerance of tocilizumab for corticosteroid sparing in giant cell arteritis and aortitis: Experience of Nimes University Hospital about eleven patients
EfficacitE et tolErance du tocilizumab en traitement d'Epargne cortisonique dans l'artErite A cellules gEantes et les aortites : expErience du centre hospitalier de NImes A propos de onze patients

Broner, J. (Auteur correspondant. ) ; Arnaud, E. ;
  • 초록  

    Abstract Introduction Giant cell arteritis is a large-vessels vasculitis, which treatment consists in a slowly-tappered steroid-therapy. Immunosuppressive agents are sometimes used in case of steroid-dependance. We have conducted an observationnal retrospective study including patients treated with tocilizumab for a giant cell arteritis or an aortitis in the internal medicine department at the NImes University Hospital. Results Eleven patients were included between 2011 and 2016, who had been treated only with prednisone. Tocilizumab was used because of steroid-dependance for nine patients, delirium under steroids for one patient and unefficiency of steroids for an other patient. Infusions of tocilizumab, administred monthly at 8mg/kg, led to clinical and biological remission for all patients. Consequently, prednisone was tappered under 10mg/d for ten patients after six months of treatment with tocilizumab. Eight cases of non-severe infection were reported; also two cases of dyslipidemia, one case of prurit and one case of moderate neutropenia. Two relapses were observed after the end of treatment, in patients treated with less than twelve infusions. Conclusion Tocilizumab could be efficient and well-tolerated in steroid-dependent giant cell arteritis and aortitis. The modalities of its use remain to be precised.


    REsumE Introduction L’artErite A cellules gEantes est une vascularite des gros vaisseaux dont le traitement consiste en une corticothErapie progressivement dEcroissante. Un traitement immunosuppresseur est parfois proposE en cas de corticodEpendance. Nous avons conduit une Etude rEtrospective observationnelle incluant les patients traitEs par tocilizumab pour une artErite A cellules gEantes ou une aortite dans le service de mEdecine interne du CHU de NImes. REsultats Onze patients Etaient inclus entre 2011 et 2016, tous initialement traitEs exclusivement par cortisone. Le recours au tocilizumab Etait dEcidE en raison d’une corticodEpendance pour neuf patients, d’une confusion sous cortisone chez un patient et d’une inefficacitE de la corticothErapie chez un autre patient. La perfusion mensuelle de tocilizumab A 8mg/kg permettait d’obtenir la rEmission clinique et biologique chez tous les patients, autorisant une diminution de la posologie de prednisone en dessous de 10mg/j aprEs six mois de traitement chez dix d’entre eux. Huit Episodes infectieux non sEvEres Etaient rapportEs, ainsi que deux cas de dyslipidEmie, un cas de prurit et un cas de neutropEnie peu profonde. Deux cas de rechute aprEs l’arrEt du tocilizumab Etaient observEs, chez des patients ayant reCu moins de douze perfusions. Conclusion Le tocilizumab pourrait Etre une molEcule efficace et bien tolErEe dans les artErites A cellules gEantes et les aortites corticodEpendantes. Ses modalitEs d’utilisation restent A prEciser.


  • 주제어

    Artérite à cellules géantes .   Corticothérapie .   Corticodépendant .   Tocilizumab .   Aortite .   Giant cell arteritis .   Steroid therapy .   Steroid dependent .   Tocilizumab .   Aortitis.  

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