Purpose Of Review: The recent approval of tocilizumab (TCZ) for the treatment of giant cell arteritis (GCA) has changed the landscape for management of this disease. Herein, we review recent literature addressing practical questions for the clinician regarding the use of TCZ in GCA. We evaluate efficacy of TCZ across different disease phenotypes, optimal dosing and formulation, treatment-related toxicity, recommendations for monitoring disease, and duration of therapy.
Recent Findings: Post-hoc analyses of a large clinical trial and real-world data suggest efficacy of TCZ across various disease phenotypes in GCA, and support use of weekly subcutaneous dosing over every-other-week dosing. More data are needed to guide duration of TCZ therapy, optimal disease activity monitoring in patients treated with TCZ, and to speak to efficacy in GCA with large vessel involvement.
Summary: TCZ has added valuably to the treatment arsenal in GCA, though more data are needed to guide optimal use of the drug.
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http://dx.doi.org/10.1097/BOR.0000000000000937 | DOI Listing |
Zhongguo Shi Yan Xue Ye Xue Za Zhi
December 2024
Department of Hematology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, Jiangsu Province, China.
Vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome (VEXAS) is a recently discovered adult-onset autoinflammatory syndrome characterized by methionine somatic mutations affecting the activation of ubiquitin system in the X-linked gene . Patients present with a wide range of inflammatory manifestations (fever, neutrophil dermatosis, chondritis, pulmonary infiltrates, ocular inflammation, venous thrombosis) and hematological impairment (giant cell anemia, thrombocytopenia, bone marrow and pre-erythrocyte vacuoles, bone marrow dysplasia), consequently contributing to significant morbidity and mortality. Current treatment management method is not well developed, and the main existing therapies are aimed at controlling inflammatory symptoms or targeting mutations.
View Article and Find Full Text PDFInt J Womens Health
December 2024
Department of Obstetrics and Gynecology, Lucerne Cantonal Hospital, Lucerne, 6000, Switzerland.
Douglas abscesses (DA) involving the ovaries and/or fallopian tubes and tubo-ovarian abscesses (TOA) constitute a very rare finding in virginal females. Underlying conditions are suspected to play a role in their development; often however, the exact pathomechanism remains hypothetical or unknown. We report the case of a 19-year-old virginal female who was referred to our outpatient clinic for further clarification of a 6-month ongoing secondary amenorrhea.
View Article and Find Full Text PDFGen Thorac Cardiovasc Surg Cases
December 2024
Department of Cardiovascular Surgery, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
Background: Takayasu arteritis is a large-vessel vasculitis, in addition to giant cell arteritis. Various post-operative complications associated with the cardiac macrovasculature have been reported. Detachment of the prosthetic valve, pseudoaneurysm formation, and dilatation of the aortic root are well-known post-operative complications associated with vasculitis syndromes, including Takayasu arteritis.
View Article and Find Full Text PDFRMD Open
December 2024
Unit of Rheumatology, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
Background: Vascular inflammation persists in temporal artery biopsy (TAB) of giant cell arteritis (GCA) patients even after prolonged glucocorticoid (GC) therapy. We aimed to evaluate the histological impact of adding tocilizumab (TCZ) to GCs.
Methods: We enrolled all consecutive GCA patients with an inflammed TAB at diagnosis who were treated with TCZ and GCs for ≥6 months and followed from December 2017 to December 2023.
J Med Virol
January 2025
Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, State Key Laboratory of Advanced Medical Materials and Devices, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China.
Multinucleated cells are present in lung tissues of patients infected by SARS-CoV-2. Although the spike protein can cause the fusion of infected cells and ACE2-expressing cells to form syncytia and induce damage, how host cell responses to this damage and the role of DNA damage response (DDR) signals in cell fusion are still unclear. Therefore, we investigated the effect of SARS-CoV-2 spike protein on the fusion of homologous and heterologous cells expressing ACE2 in vitro models, focusing on the protein levels of ATR and ATM, the major kinases responding to DNA damage, and their substrates CHK1 and CHK2.
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