In giant cell arteritis (GCA), the TREAT GCA trial evaluated which biologic that is now approved for GCA to reduce relapse and cumulative glucocorticoid dose?
- A Rituximab (anti-CD20)
- B Tocilizumab (IL-6 receptor antagonist) ✓
- C Belimumab (anti-BLyS)
- D Abatacept (CTLA-4-Ig)
Correct answer: B. Tocilizumab (IL-6 receptor antagonist)
Explanation
The GiACTA trial (published 2017 in NEJM) demonstrated that tocilizumab (subcutaneous weekly or every-2-week) plus prednisolone tapering achieved sustained remission in 56% and 53% respectively vs 14–18% with prednisolone alone at 52 weeks. Tocilizumab (anti-IL-6 receptor) is FDA/EMA-approved for GCA and is the only biologic approved for this indication. Rituximab, belimumab, and abatacept lack this specific trial evidence and approval for GCA.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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