Clinical outcomes of patients with giant cell arteritis treated with tocilizumab in real-world clinical practice: decreased incidence of new visual manifestations

Table 5 Clinical outcomes in patients with and without visual manifestations at diagnosis

	Patients with visual manifestations at diagnosis (n = 22)		Patients without visual manifestations at diagnosis (n = 38)
	Before TCZ initiation	After TCZ initiation	Before TCZ initiation	After TCZ initiation
Follow-up time, median (IQR), years	0.37 (0.20–0.92)	0.86 (0.28–1.16)	0.86 (0.18–1.84)	0.56 (0.37–1.73)
Rate of flares per year*
Rate (95% CI)	1.2 (0.6, 2.5)	0.4 (0.1–1.2)	1.5 (0.9–2.4)	0.6 (0.3–1.2)
Rate ratio (95% CI)		0.3 (0.1–0.8)		0.4 (0.3–0.7)
p value		0.021		0.003
Patients with ≥ 1 flare, n (%)	15 (68.2)	4 (18.2)	28 (73.7)	14 (36.8)
Patients with ≥ 1 flare with visual manifestations, n (%)^†	9 (40.9)	2 (9.1)	5 (13.2)	1 (2.6)
Permanent vision loss	1 (4.5)	0	1 (2.6)	0
AION	1 (4.5)	0	1 (2.6)	0
CRAO	0	0	0	0
Temporary vision impairment	9 (40.9)	2 (9.1)	5 (13.2)	1 (2.6)
Amaurosis fugax	2 (9.1)	1 (4.5)	2 (5.3)	0
Blurred vision	8 (36.4)	2 (9.1)	4 (10.5)	1 (2.6)
Diplopia	1 (4.5)	0	1 (2.6)	0
Total no. of flares	29	9	73	28
Total flares with visual manifestations, n (%)^†	10 (34.4)	2 (22.2)	5 (6.8)	1 (3.6)
Permanent vision loss	1 (3.4)	0	1 (1.4)	0
AION	1 (3.4)	0	1 (1.4)	0
CRAO	0	0	0	0
Temporary vision impairment	10 (34.4)	2 (22.2)	5 (6.8)	1 (3.6)
Amaurosis fugax	2 (6.8)	1 (11.1)	2 (2.7)	0
Blurred vision	9 (31.0)	2 (22.2)	4 (5.5)	1 (3.6)
Diplopia	1 (3.4)	0	1 (1.4)	0

AION anterior ischemic optic neuropathy, CRAO central retinal artery occlusion, GCA giant cell arteritis, IQR interquartile range, TCZ tocilizumab
*Rates were estimated from a Poisson regression model with ongoing treatment (TCZ and glucocorticoid combinations), age, smoking history, and new or relapsing GCA as covariates, and random patient effect
^†Symptoms were after GCA diagnosis. Percentage of flares is out of the total number of flares

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