#3-54E. Beyond the First Year: Tocilizumab Duration and Relapse Risks in Giant Cell Arteritis (Rheumatol Ther, 2026)

Managing Giant Cell Arteritis (GCA) presents the persistent clinical challenge of preventing ischemic complications while minimizing the toxicity of long-term glucocorticoids. This retrospective cohort study by Makhzoum et al. examines real-world treatment patterns and outcomes in 121 Canadian patients, stratified by regimens including glucocorticoid monotherapy and tocilizumab (TCZ) combination therapy. The researchers found that while TCZ-treated patients achieved the lowest cumulative steroid exposure, sustaining remission remained difficult; notably, methotrexate showed limited steroid-sparing efficacy, and nearly half of the overall cohort eventually experienced a relapse. The most critical finding for clinical practice is that roughly 25% of patients relapsed specifically after discontinuing TCZ—often precipitated by a rigid one-year reimbursement limit—suggesting that fixed-duration therapy is frequently inadequate for long-term disease control. However, listeners should critically appraise these findings in light of the study's single-center, retrospective design, which carries inherent risks of selection bias regarding which patients received biologics. For physicians, this evidence underscores the necessity of individualized, potentially extended biologic therapy beyond standard administrative timelines, emphasizing that tapering decisions should be driven strictly by disease activity to ensure sustained steroid-free remission.

Citation: Makhzoum JP, Avadisian M, Liazoghli D. Treatment Patterns and Clinical Outcomes for Patients Living with Active Giant Cell Arteritis in Canada. Rheumatol Ther. 2026. DOI: 10.1007/s40744-025-00817-y

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