Table 3.

Summary of additional data from 16 patients with giant cell arteries started on tocilizumab

Symptoms	Clinically, the most common symptoms on presentation were headache and jaw pain/claudication, each present in 75% of the patients (12 of 16 cases) Visual loss was present in 7 of the 16 cases, on a spectrum from blurry vision to complete visual loss in 3 individuals. Scalp tenderness was also present in 7 of the 16 cases Six cases reported weight loss, and three reported low appetite Six of the cases reported lethargy on presentation, and five reported sweats. Four described proximal myalgia More uncommon symptoms were reported in one to two cases each—including nausea, dizziness, early morning stiffness, and joint pain
Comorbidities	Seven of the 16 cases had a confirmed diagnosis of polymyalgia rheumatica, and two had existing rheumatoid arthritis. One had Takayasu’s arteritis—another large vessel vasculitis, and one had an additional unclassified vasculitis. The remaining five patients therefore had no additional primary rheumatological conditions
Investigations	Five of the 13 patients who had a temporal artery biopsy (TAB) were positive for GCA, with two samples inconclusive. Seven cases therefore had a negative biopsy, highlighting the established difficulties on reliance on TAB for diagnosis
Concurrent medication	Five cases were concurrently on methotrexate, with a dose range between 15 and 25 mg once weekly, and one additional case was on leflunomide as methotrexate was ineffective for them Thirteen of 16 cases were on vitamin D/calcium, 11 on alendronate, 9 on aspirin (with 1 further case on warfarin), and 15 on a gastroprotective agent (proton pump inhibitor/H2 receptor antagonist). Twenty-five percent were on a statin
Methylprednisolone	Fifty percent of cases required a 3-day intravenous methylprednisolone course, including all three of the cases with complete visual loss
Relapse	A relapse of GCA is defined as “the return of signs and/or symptoms with or without changes in inflammatory markers after reduction of therapy”[5], and this occurred for 13 of 16 cases. Five of these 13 cases had one relapse, four had two relapses, and the remaining four had multiple relapses (three or more)