ABS0467 INTRAVENOUS VERSUS SUBCUTANEOUS ADMINISTRATION OF TOCILIZUMAB IN AORTITIS ASSOCIATED WITH GIANT CELL ARTERITIS: MULTICENTER OPEN-LABEL STUDY OF 196 PATIENTS.

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Background: Giant cell arteritis (GCA) may present with aortitis as one of the most severe manifestations. Tocilizumab (TCZ) has demonstrated efficacy in large-vessel vasculitis (LVV) including GCA. However, there are no studies comparing intravenous (IV) vs subcutaneous (SC) administration of TCZ in aortitis related to GCA (GCA-aortitis). Objectives: Our aim was to compare the effectiveness of TCZ in GCA-aortitis according the route of administration (IV vs SC) in a wide series of patients in a clinical world setting. Methods: Multicenter study of 196 patients diagnosed with GCA-aortitis by imaging techniques and treated with TCZ. Patients were divided in two groups according to the route of administration of TCZ: i) IV, and ii) SC. GCA was diagnosed by 1990 ACR criteria, and/or temporal artery biopsy and/or imaging techniques. Aortitis was diagnosed mainly by 18F-FDG-PET/CT. Main outcomes were EULAR remission definition (clinical remission and normalization of CRP and ESR), imaging remission (considered when vascular FDG uptake was less than liver uptake in 18F-FDG PET/CT) and glucocorticoid withdrawal after TCZ initiation. Results: One hundred and ninety six patients (mean age 69.8±9.4 years) treated with TCZ were included. One hundred and ten received IV-TCZ and 86 SC-TCZ (Table 1). Time between diagnosis of aortitis-GCA and TCZ initiation was shorter in SC group, although without reaching statistical significance. Interestingly, no differences in acute phase reactants were observed at TCZ initiation between both groups. There were no differences between the two routes of TCZ administration in glucocorticoid-sparing effect after TCZ initiation. Noticeably, statistical differences in EULAR remission definition were observed after 24-month follow-up, although there were no differences in imaging remission (Figure 1). Conclusion: In GCA-aortitis, SC TCZ might be more effective than IV in achieving the EULAR remission target in clinical practice conditions after 24-month follow-up. REFERENCES: [1] Martín-Gutiérrez A, et al. Eur J Intern Med. 2024. PMID: 38908981. [2] Loricera J, et al. Clin Exp Rheumatol. 2015. PMID: 25437450. [3] Loricera J, et al. Clin Exp Rheumatol. 2014. PMID: 24854377. Figure 1Evolution of main outcomes in patients with GCA- aortitis treated with TCZ. A comparison between intravenous and subcutaneous TCZ. (A) Prednisone dose (mg/day). (B), (C) EULAR and imaging remission at 6, 12 and 24 months. * p<0.05 Acknowledgements: NIL . Disclosure of Interests: Carmen Secada-Gómez: None declared, Javier Loricera Roche, Galápagos, Novartis, UCB Pharma, MSD, Celgene, Astra Zeneca and Grünenthal, Janssen, Abbvie, Roche, Novartis, MSD, UCB Pharma, Celgene, Lilly, Pfizer, Galápagos, Adrián Martín-Gutiérrez: None declared, Santos Castañeda BMS, Eli-Lilly, MSD, Roche and UCB, MSD, Pfizer and UCB, Ricardo Blanco AbbVie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly, UCB, and MSD, AbbVie, MSD, and Roche. © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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