Department of Rheumatology, Danderyd Hospital, Stockholm, Sweden.
Clin Exp Rheumatol. 2020 Mar-Apr;38 Suppl 124(2):207-209. Epub 2020 May 1.
Giant cell arteritis (GCA), a systemic large-vessel vasculitis, is a disease that has been treated with glucocorticoids since 1950. Over the years, several disease-modifying anti-rheumatic drugs have been evaluated as steroid-sparing agents with disappointing results. Tocilizumab, an interleukin-6 inhibitor, has in recent years been approved for the treatment of GCA. It remains uncertain whether the drug suppresses disease activity and maintains remission or just alleviates the symptoms and masks the signs of smoldering disease. This case describes the clinical findings at diagnosis and the course of the disease with the subsequent development of intracranial vasculitis in a 70-year-old male treated with tocilizumab. The present case illustrates the need for further studies regarding tocilizumab in the treatment of GCA patients and the need for meticulous evaluation at follow-ups.
巨细胞动脉炎（GCA）是一种系统性大血管血管炎，自 1950 年以来一直采用糖皮质激素治疗。多年来，已评估了几种改善病情的抗风湿药物作为类固醇助减剂，但结果令人失望。白细胞介素-6 抑制剂托珠单抗近年来已被批准用于治疗 GCA。目前尚不确定该药物是抑制疾病活动并维持缓解，还是仅缓解症状并掩盖潜在疾病的迹象。本病例描述了一名 70 岁男性患者在接受托珠单抗治疗时的诊断时临床发现和疾病过程，随后发展为颅内血管炎。本病例说明需要进一步研究托珠单抗在 GCA 患者治疗中的应用，并需要在随访时进行细致的评估。
