Pos0926 Real-World Effectiveness and Safety of Tocilizumab in Patients With Polymyalgia Rheumatica

Background: Polymyalgia rheumatica (PMR) responds well to treatment with glucocorticoids, but high relapse rates during glucocorticoid tapering and adverse events associated with long-term glucocorticoid use are problematic. Tocilizumab, an anti-interleukin-6 receptor inhibitor, is approved for rheumatoid arthritis and giant cell arteritis, and recent clinical trials have reported its efficacy in PMR 1, 2, but the real-world data on tocilizumab in PMR are still unclear. Objectives: This study aims to evaluate the effectiveness and safety of tocilizumab in patients with PMR in clinical practice. Methods: We reviewed consecutive patients with PMR treated with tocilizumab at Keio University Hospital from May 2012 to October 2022. Patients complicated with active giant cell arteritis were excluded. We collected clinical data, including PMR-activity score (AS), prednisolone dosage, recurrence, and adverse events. Recurrence was defined as worsening of symptoms that required intensification of treatment, including initiation or increase in glucocorticoids, immunosuppressants, or tocilizumab, as well as shortening the interval of tocilizumab. Results: We identified 55 patients with PMR who were treated with tocilizumab. Tocilizumab was initially administered 8 mg/kg intravenously every 4 weeks (n = 33) or 162 mg/body subcutaneously every 2 weeks (n = 22). The median age at tocilizumab initiation was 76.2 (interquartile range IQR: 67.8-80.2) years and 40 (72.7%) were female. All patients were treated with prednisolone at the median dose of 8.0 (IQR: 6.0-11.0) mg/day at tocilizumab initiation, with 44 (80.0%) patients having had at least one recurrence before tocilizumab initiation with a median prednisolone dose of 7.3 (IQR: 5.0-10.0) mg/day. The median observation period from tocilizumab initiation to the last visit was 2.8 (IQR: 1.0-5.4) years. PMR-AS significantly improved after tocilizumab initiation from 0.51 (IQR: 0.11-3.22) to 0.05 (IQR: 0.02-0.23)(P Conclusion: Tocilizumab is a useful treatment option with glucocorticoid sparing effects in patients with PMR in real world. REFERENCES: 1 Ann Rheum Dis. 2022;81:838–844. 2 JAMA. 2022;328:1053-1062. Acknowledgements: NIL. Disclosure of Interests: None declared.