Division of Rheumatology, Department of Medicine, University of Michigan, Ann Arbor, Michigan.
Barnard College, New York, New York, USA.
Curr Opin Rheumatol. 2023 May 1;35(3):135-140. doi: 10.1097/BOR.0000000000000937. Epub 2023 Mar 9.
The recent approval of tocilizumab (TCZ) for the treatment of giant cell arteritis (GCA) has changed the landscape for management of this disease. Herein, we review recent literature addressing practical questions for the clinician regarding the use of TCZ in GCA. We evaluate efficacy of TCZ across different disease phenotypes, optimal dosing and formulation, treatment-related toxicity, recommendations for monitoring disease, and duration of therapy.
Post-hoc analyses of a large clinical trial and real-world data suggest efficacy of TCZ across various disease phenotypes in GCA, and support use of weekly subcutaneous dosing over every-other-week dosing. More data are needed to guide duration of TCZ therapy, optimal disease activity monitoring in patients treated with TCZ, and to speak to efficacy in GCA with large vessel involvement.
TCZ has added valuably to the treatment arsenal in GCA, though more data are needed to guide optimal use of the drug.
托珠单抗（TCZ）最近被批准用于治疗巨细胞动脉炎（GCA），改变了这种疾病的治疗格局。本文综述了最近关于 TCZ 在 GCA 中的临床应用的文献，探讨了与 TCZ 相关的一些实际问题。我们评估了 TCZ 在不同疾病表型中的疗效、最佳剂量和剂型、治疗相关毒性、疾病监测建议以及治疗持续时间。
一项大型临床试验的事后分析和真实世界的数据表明 TCZ 在 GCA 的各种疾病表型中均有效，并支持每周皮下给药优于每两周给药。需要更多的数据来指导 TCZ 治疗的持续时间、接受 TCZ 治疗的患者最佳疾病活动监测，以及探讨 TCZ 在伴有大血管受累的 GCA 中的疗效。
TCZ 为 GCA 的治疗提供了有力的武器，但仍需要更多的数据来指导该药的最佳应用。
