Table 2

Prospective, follow-up imaging studies monitoring the therapeutic response of tocilizumab on vascular inflammation in giant cell arteritis (GCA)

AuthorDisease subset (no of patients)Duration of follow-upDisease activity at follow-upBiochemical activityUltrasoundMR
angiography
18F-Fluorodeoxyglucose positron emission tomography
Adler et al33New-onset
Relapsing
LV-GCA (n=9)
12 mo on TCZ +
28.1 (17–44) mo
Remission: n=9
(clinical and laboratory definition)
  • Low CRP and ESR under TCZ

  • Normal biomarkers*

Not performedPersisting wall enhancement of the aorta in all patients in treatment-free remissionNot performed
Prieto Peña et al47Relapsing
C-/LV-GCA (n=7)
LV-GCA (n=23)
Mean
10.8±3.7 mo
Remission: n=25 (83%)
(clinical and laboratory definition)
Low CRP and ESR under TCZNot performedNot performed
  • Mean TVS decreased from 4.97±2.62 to 3.13±1.89 (p<0.001)

  • Mean thoracic TBR decreased from 1.70±0.52 to 1.48±0.25 (p=0.005)

  • Normalisation TVS in n=3 (10%)

  • Normalisation TBR in n=9 (30%)

Quinn et al49New-onset
Relapsing
(n=25)
Up to 24 moAt 18–24 months: remission in n=22 of 25 (88%)
(clinical definition)
Not specifiedNot performedNot performedAt 18–24 mo (n=12): Median PETVAS decreased from 24.0 (22.3–27.0) to
18.5 (15.3–23.8); p<0.01.
Schönau et al48New-onset (n=19) treated with TCZ +GCMean
15.3±11.8 mo
Remission: n=13, 68.4%
(clinical and laboratory definition)
Low CRP and ESR under TCZNot performedNot performedPETVAS decreased from 19.8 to 7.5 (p=0.0002)
Sebastian et al46Relapsing
C-GCA (n=10)
LV-GCA (n=10)
C-/LV-GCA (n=2)
43 (12–52) wk
Only 4 patients (18%) completed the 12 mo TCZ
  • At 52 wk: n=3 of 4 in remission

  • At <52 wk: n=15 in remision

(clinical definition)
Low CRP and ESR under TCZ
  • Decreased TA HS (median 11 to 0; n=5)

  • Stable AA HS (n=8)

 Not performedMedian TVS decreased after starting TCZ (median 11.5 to 6.5; n=4).
Seitz et al50New onset (n=18)
C-GCA (n=16)
LV-GCA (n=6) treated with
intravenously 500 mg GC during 3 days
52 wk
  • Baseline: active

  • Day 2–3: n=0 in remission

  • 4 wk: n=3 in remission

  • 24 wk: n=14 in remission

  • 52 wk: unclear

(clinical definition)
Not specified
  • Baseline (IMT):

    TA: 2.48; AA/SA: 1.36

  • Day 2–3:

    TA: 2.16; AA/SA: 1.21

  • 4 wk:

    TA: 2.50; AA/SA: 1.42

  • 24 wk:

    TA: 1.79; AA/SA: 1.54

  • 52 wk:

    TA: 1.55; AA/SA: 1.48

Not performedNot performed
  • *Interleukin-6, matrix metalloproteinase-3, soluble tumour necrosis factor receptor 2, soluble CD163, soluble intercellular adhesion molecule-1, pentraxin-3.

  • AA, axillary artery; C-GCA, cranial GCA; CRP, C reactive protein; ESR, erythrocyte sedimentation rate; GC, glucocorticoids; HS, Halo Score; IMT, intima–media thickness; LV-GCA, large vessel GCA; mo, month; PETVAS, Positron Emission Tomography Vascular Activity Score; SA, subclavian artery; TA, temporal artery; TBR, Target to Background ratio; TCZ, tocilizumab; TVS, Total Vascular Score; wk, week.