ULTRASOUND SHOWS ONGOING VESSEL WALL REMODELING IN GIANT CELL ARTERITIS FOR TWO YEARS AFTER DISCONTINUATION OF TOCILIZUMAB – FOLLOW-UP OF THE GUSTO TRIAL
Abstract: POS0693
Authors: L. Seitz et al.
Little is known about potential ongoing vessel wall inflammation in clinical and laboratory remission of Giant Cell Arteritis (GCA). Even less is known about wall changes in lasting drug-free remission.
Key Content:
Arterial vessel wall was assessed measuring the intima-media thickness (IMT) in the GUSTO trial (Giant cell arteritis (GCA) treatment with Ultra-Short glucocorticoids and TOcilizumab). It showed a steady decrease over time. The objective of this study was to investigate the evolution of the IMT after discontinuation of TCZ until week 156.
The new Outcome Measures in Rheumatology (OMERACT) GCA ultrasonography score (OGUS) for monitoring disease activity in GCA was applied. It is calculated as follows: IMT divided by the rounded cut-off values of IMTs for each segment; the sum of these values is then divided by the number of segments available (maximum of 8 segments; axillary and temporal arteries considered).
The maximum IMT of the temporal arteries (common superficial temporal artery, parietal and frontal branch) and IMT at landmarks of the axillary and subclavian arteries were measured bilaterally at weeks 52, 78, 104 and 156. The OGUS showed a steady decline with mean values of 0.90 (standard deviation (SD) 0.19) at week 52, 0.87 (SD 0.16) at week 78, 0.84 (SD 0.15) at week 104, and 0.79 (SD 0.12) at week 156.
Relevance:
After 52 weeks of treatment with TCZ, the IMT in GCA continues to decline. It can take more than one year for the OGUS to become smaller than 1, indicating an average IMT below the rounded diagnostic cut-off values. Our results suggest a long-lasting remodelling phase of the vessel wall after treatment discontinuation.
