Recommended Reading – Giant Cell Arteritis Treatment – Anti-Interleukin-6 Antibody

Recommended Reading – Giant Cell Arteritis Treatment – Anti-Interleukin-6 Antibody

IL-6 Blockade and its Therapeutic Success in Giant Cell Arteritis
Sebastian Unizony, MD, Tanaz A. Kermani, MD, MS: J Neuro-Ophthalmol 2018; 00: 1-8
CONCLUSIONS AND FUTURE PERSPECTIVES
Until recently, therapies that could maintain disease remission and prevent the well-known toxicity associated with excessive CS exposures have been the greatest unmet need for the GCA population. Studies elucidating the role of IL-6 in the inflammatory cascade in general and in the pathogenesis of GCA in particular have been instrumental in the eventual success of IL-6 blockade for the treatment of this condition. Further research is now required to answer several outstanding questions pertaining to the duration of TCZ treatment, the use of CS in patients receiving TCZ (e.g., can TCZ be used in monotherapy?), and whether TCZ is effective in controlling arterial inflammation and preventing large-artery complications. These and other questions will fine tune the use of TCZ for GCA. In addition, IL-6 inhibition has made even more pressing the need for accurate biomarkers to monitor disease activity and response to treatment.

More than 25 years passed from the initial observations that patients with GCA demonstrate an increased IL-6 signal to the demonstration of the efficacy of IL-6 blockade in rigorous clinical trials. We should do better. Fortunately, our understanding of the mechanisms of disease involved in GCA has improved and will likely continue to evolve in the future leading to the discovery of other important pathways and targeted treatment strategies

Full Text https://drive.google.com/open?id=1RUM9u7PRCekCpiDj-l9Ksf2eLCqne3xU  

 

Anti-Interleukin-6 Antibody as Treatment for Giant Cell Arteritis
Joyce Liao: J Neuro-Ophthalmol 2018; 00: 1-3
Choosing the right treatment for patients with GCA remains challenging. Although there is now an approved alternative to corticosteroids, our experience with TCZ is still limited compared with more than 6 decades of experience with corticosteroids. TCZ has promising efficacy in GCA, but there have been several reports of clinically significant, albeit rare, side effects such as severe neutropenia, recurrent pneumonia, cytomegalovirus, and other infections (30–32). Further research into the pathogenesis of GCA and the development of new therapies that can reverse vision loss and prevent relapse are critically needed.

Full Text https://drive.google.com/open?id=1gW9gf4HKGtg6onQtKliREMb2mYR9otzc