Vasculitis and Giant Cell Arteritis News

BOSTON — New and emerging treatment strategies, including the anti-interleukin-6 agent tocilizumab, have established a “new era” of giant cell arteritis management, allowing rheumatologists and their patients to move on from the use of corticosteroids, according to a presentation here at the 2018 Interdisciplinary Autoimmune Summit.

Giant cell arteritis (GCA) is the most common form of medium- and large-vessel vasculitis. If left untreated, patients with GCA are at increased risk for a range of short- and long-term complications. Diagnosis of GCA remains difficult due to the nonspecific nature of many early symptoms. Until recently, therapeutic options were limited to prolonged, high-dose glucocorticoid therapy, which has the potential for many undesirable side effects. In this CME activity, expert faculty will discuss the clinical and immunopathologic features of GCA, current therapeutic options, as well as data for new and emerging agents. Case-based discussion will provide practical strategies for overcoming the diagnostic and treatment challenges of GCA.

As rheumatologists, we relish new cases of giant cell arteritis in their classic form. We have the capacity to make a bedside diagnosis with considerable diagnostic accuracy when confronted by the elderly patient with new-onset headache, jaw claudication, polymyalgia with a tender and pulseless temporal artery. In reality, of course, this is not often the case.

The FDA has rejected approval of Celltrion’s biologics license applications for Truxima, a proposed rituximab biosimilar, and Herzuma, a proposed trastuzumab biosimilar, issuing Complete Response Letters for both products.

Many rheumatic diseases – including systemic lupus erythematous, scleroderma and the various forms of psoriasis – present with a multitude of dermatologic symptoms that clinicians can easily confuse with other conditions.

Apremilast was successful in significantly reducing oral ulcers in patients with Behçet’s Disease compared with placebo in a phase 3 study, according to findings presented at the 2018 American Academy of Dermatology Annual Meeting in San Diego.

Researchers reported significant declines in the mortality rates of patients diagnosed with end-stage renal disease caused by granulomatosis with polyangiitis during the past 2 decades, which is likely due to improved management of such patients.

The European League Against Rheumatism has published its first-ever guidance on the role of imaging in the diagnosis and monitoring of patients with large vessel vasculitis, determining, among other recommendations, that all individuals suspected of having such conditions receive early imaging tests.

Although herpes zoster may increase the risk for giant cell arteritis, according to findings published in Arthritis and Rheumatology, antiviral treatment and vaccination did demonstrate any consistent benefit in reducing this risk.

The FDA has expanded the approved use of Nucala to treat adult patients with eosinophilic granulomatosis with polyangiitis, a rare autoimmune disease that causes vasculitis.