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Retrospective real-world data point to high response rates in patients with giant cell arteritis (GCA) failing standard treatment.

Retrospective real-world data point to high response rates in patients with giant cell arteritis (GCA) failing standard treatment. After 12 months, 70% and 65% attained clinical remission or complete remission, respectively.

Since the JAK/STAT pathway plays a role in GCA, Fernando López Gutiérrez, MD, (and colleagues were interested in the safety and efficacy of JAK inhibitors as treatment for patients who relapsed while on treatment with glucocorticoids, methotrexate, and tocilizumab. They performed a retrospective investigation with real-world data of patients in routine clinical practice.

The study included 35 patients who received treatment with either baricitinib (n=15), tofacitinib (n=10), or upadacitinib (n=10). Clinical remission and complete remission outcomes were assessed up to 1 year after starting JAK inhibition. The patients had a mean age of 72.3 years, and 86% were women. Before commencing JAK inhibition, GCA was known for a median of 30 months; 43% suffered from headaches, and 57% had large-vessel involvement. Median CRP was 0.9 mg/dL, and median ESR was 28 mm/1^st hour. Previous experience with methotrexate was present in 63% and tocilizumab in 86. The median daily dose of prednisone was 16.2 mg.

At 1 year, 70% of treated patients achieved clinical remission, climbing from 51% at 1 month to 54% at 3 months, and 61% after 6 months. Corresponding proportions for complete remission were 65%, 43%, 48%, and 57%.

Five patients reported adverse events: one case each of herpes zoster, urinary tract infection, elevation of liver enzymes, and glioblastoma multiforme, and one patient with dyspnoea and palpitations.

The authors recommend that randomized controlled trials confirm these results, which suggest the efficacy of JAK inhibitors in GCA patients who fail standard-of-care options.

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