Tocilizumab in patients over 80 years old with giant cell ar
A Study was conducted to assess the efficacy and tolerance of tocilizumab (TCZ) in giant cell arteritis (GCA) patients over 80 years that proved to show the positive results.

GCA patients over 80 years old from the French Study Group for Large Vessel Vasculitis register who received TCZ were analyzed.

--21 GCA patients (median age 84 [81–90] years old, including nine over 85) received TCZ for the following nonexclusive reasons: glucocorticoid (GC)-sparing effect in 14, relapsing disease in 8, disease severity in 4, and/or failure of another immunosuppressant in 4.

--TCZ was introduced with GCs at diagnosis in 6 patients and at 8 months after GC initiation in 15 others.

--After a median delay of 8 months post-TCZ introduction, 14 patients were able to definitively stop GCs, including 6 who were GC-dependent before TCZ.

--At the last follow-up, 11 patients had definitively stopped TCZ, and 2 additional patients had stopped but relapsed and resumed TCZ.

--7 patients experienced 11 adverse events: hypercholesterolemia in 4 patients; infections, i.e., pyelonephritis, bronchitis, and fatal septic shock associated with mesenteric infarction following planned surgery (GCs were stopped for 1 year and TCZ infusions for 2 months), respectively, in 3 patients; moderate thrombocytopenia and moderate neutropenia in 2 patients; and a 5-fold increase in transaminase levels in another that improved after TCZ dose reduction.

Finally, in the oldest GCA patients, TCZ remains a valuable GC-sparing choice with an intriguing risk-benefit ratio. One-third of the patients experienced mild-to-moderate side effects.