Biological agents for giant cell arteritis: treat to target

Another randomised, placebo-controlled trial ( NCT02531633 ) aims to study sirukumab (a fully human anti-IL-6 immunoglobulin G1[kappa]) in approximately 204 subjects with a diagnosis of GCA. [...]in the nearest future we will probably face a wider use of biological agents as a second-line treatment...

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Bibliographic Details
Published inAnnals of the rheumatic diseases Vol. 75; no. 9; p. e58
Main Authors Moiseev, Sergey, Novikov, Pavel, Meshkov, Alexey, Smitienko, Ilya
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 01.09.2016
Subjects
Biological products
Biopsy
Cardiovascular disease
Heart attacks
Immunotherapy
Medical prognosis
Mortality
Older people
Patients
Psoriasis
Rheumatology
Studies
DMARDs (biologic)
Giant Cell Arteritis
Treatment
Systemic vasculitis
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Summary:Another randomised, placebo-controlled trial ( NCT02531633 ) aims to study sirukumab (a fully human anti-IL-6 immunoglobulin G1[kappa]) in approximately 204 subjects with a diagnosis of GCA. [...]in the nearest future we will probably face a wider use of biological agents as a second-line treatment for relapsing GCA and maybe as a first line in patients with more unfavourable prognosis. The isolated increase in inflammatory biomarkers is usually not sufficient to diagnose a relapse 4 while clinical scores, such as the Birmingham Vasculitis Activity Score (BVAS), have only limited utility in GCA. 5 18Fluorodeoxyglucose positron-emission tomography is a promising method though its value for evaluation of GCA activity is not established. 6 In the Conway et al study, persistent constitutional symptoms and elevated acute-phase reactants initially felt to be possibly related to active GCA were ultimately attributed to an alternative cause in two of five patients. [...]a proportion of patients with GCA may be overtreated, given the difficulties in establishing relapse of vasculitis.
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ISSN:0003-4967
1468-2060
DOI:10.1136/annrheumdis-2016-210061