The National Institute for Health and Care Excellence (NICE) has recommended tocilizumab (RoActemra) as a treatment option for giant cell arteritis (GCA).
Tocilizumab (with tapering course of glucocorticoids or alone after glucocorticoids) is recommended for the treatment of adults with relapsing or refractory giant cell arteritis who have previously not received tocilizumab. Tocilizumab should be discontinued after 1 year of uninterrupted therapy.
The recommended dose for tocilizumab is 162 mg administered subcutaneously once a week along with a tapering course of glucocorticoids. It may be administered alone after discontinuation of glucocorticoids; however, monotherapy is not recommended for treating acute relapses. The decision to continue therapy beyond 52 weeks should be guided by disease activity, physician discretion, and patient choice.
Evidence has shown that tocilizumab + tapering course of glucocorticoids for a year could improve the remission state and lower the dosage requirement for glucocorticoids compared with glucocorticoids alone.
The drug is to be used only when it is discounted by the company in agreement with the patient access scheme. The recommendations should not affect patients whose treatment with the drug was started before publication of the guidance.