Efficiency of Actemra injection in GCA

[Rajuguide]

Are actemra injection weekly with prednisone have better control of GCA, compare with prednisone alone in treatment of GCA ?

[SheffieldJane]

I have Tocilizumab/ Actemra injections plus, now, 8 mgs of Prednisalone. Having Actemra enabled me to reduce Pred much more quickly from 40 mgs to 10 mgs. It is my understanding that it enables us to reduce the steroid burden on our bodies’ and still control the inflammation of the disease ( GCA). Therefore, it is not more effective against GCA but perhaps equally so without the many downsides of steroid use - especially high dose, long term steroid use. Actemra is not without side effects though, for some patients. My Rheumatologist believes that it is preferable course of treatment for GCA and would like to see me get off Pred entirely.

[winfong in reply to SheffieldJane]

Well put. Actemra is supposed to be "steroid-sparing," not a substitute. I worked great for me until it caused me to have a perforated colon! If you have a history of diverticulitis / diverticulosis.

[DeepThought2]

Dear Rajaguide, as SheffieldJane wrote, Tocilizumab (TCZ) is mainly used to (a) inhibit the autoimmune-induced inflammation that causes GCA and at the same time to (b) reduce the cumulative amount of prednisolone needed. I was diagnosed with GCA/large vessel vasculitis in February 2021 and started with 40 mg pred plus weekly TCZ injections and could stop after rather fast tapering prednisolone in July while continuing TCZ. In clinical trials up 60% of patients can stop prednisolone after 6 months and stay symptom free with TCZ only and a (quite large) part of these symptom free patients can stop TCZ after a year without relapse. There are also side effects of TCZ but as always it is different among patients.

[PMRpro Ambassador]

nejm.org/doi/full/10.1056/n...

ard.bmj.com/content/78/Supp...

are reports of the results of the two stages of the Giacta trial using Acterma/tocilizumab in GCA>