Giant cell arteritis is a granulomatous immune-mediated vasculitis of medium and large vessels. It most commonly affects white females over the age of 50 and is the most common primary vasculitis in the United States. Treatment of this disease has classically been with high-dose corticosteroids, but this therapy has been associated with severe morbidity and mortality. Tocilizumab, a humanized monoclonal antibody targeting the interleukin-6 receptor, has been used with great efficacy and safety in rheumatoid arthritis and systemic-onset juvenile idiopathic arthritis. As interleukin-6 has been shown to be a key cytokine in giant cell arteritis, the use of an inhibiting agent has been explored. In the 15 case reports/series that were reviewed, most patients were given tocilizumab due to refractory giant cell arteritis and/or intolerance to glucocorticoid therapy, and most experienced remission of symptoms. At this time, there are only 2 randomized control trials to evaluate the efficacy and safety of tocilizumab use in giant cell arteritis. The phase II trial by Villiger et al and the GiACTA trial both showed that tocilizumab greatly increased the rate of sustained remission in giant cell arteritis over the course of 1 year. The most common adverse events were similar to those seen with use in rheumatoid arthritis: infections, neutropenia, and increases in lipids and liver function test enzymes. Based on the results of numerous case studies and the 2 randomized control trials, tocilizumab is the first agent to be approved by the Food and Drug Administration for treatment of giant cell arteritis.

中文翻译：

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巨细胞动脉炎中的Tocilizumab。

巨细胞动脉炎是大中型血管的肉芽肿性免疫介导的血管炎。它最常影响50岁以上的白人女性，并且是美国最常见的原发性血管炎。传统上，大剂量皮质类固醇可以治疗这种疾病，但是这种治疗与严重的发病率和死亡率有关。Tocilizumab是一种针对白介素6受体的人源化单克隆抗体，已在类风湿关节炎和全身发作的幼年特发性关节炎中得到了极大的疗效和安全性。由于已经证明白介素6是巨细胞动脉炎中的关键细胞因子，因此已经探索了抑制剂的使用。在审查的15个案例报告/系列中，大多数患者由于难治性巨细胞动脉炎和/或对糖皮质激素治疗不耐受而接受了托珠单抗治疗，并且症状最缓解。目前，只有2项随机对照试验评估托珠单抗在巨细胞动脉炎中的疗效和安全性。Villiger等人进行的II期试验和GiACTA试验均表明，tocilizumab在1年的时间里大大提高了巨细胞动脉炎的持续缓解率。最常见的不良事件与类风湿关节炎相似：感染，中性粒细胞减少，脂质和肝功能测试酶升高。根据大量案例研究的结果和2项随机对照试验，