Quick, Vanessa and Sah, Stephen and Dubey, Shirish and Mercer, Louise and Nair, Jagdish R and Coath, Fiona L and Kurshid, Muhammad and Abusalameh, Mahdi and Ahmed, Sajeel and Alkoky, Hoda and Bukhari, Marwan and Carter, Stuart and Davidson, Brian and Doddamani, Parveen and Ducker, Georgina and Griffiths, Bridget and Gullick, Nicola and Heaney, Jonathan and Holloway, Amelia and Htut, Ei Ei Phyu and Hughes, Mark and Irvine, Hannah and Kinder, Alison and Lim, Joyce and Ludwig, Dalia R and Malik, Mariam and Mulhearn, Ben and Patel, Rikesh and Robson, Joanna and Saha, Pratyasha and Tansley, Sarah and Mackie, Sarah L and Ahmed, Saad and Atchia, Ismael and Bluett, James and Connew, Alex and Coulson, Elizabeth and Crawshaw, Helena and Davies, Ursula and Lord, Denise De and Dulay, Gurdeep and Embuldeniya, Amanda and Carmen, Fonseca and Galloway, James and Gubbins, William and Guruparan, Thushyanthan and Heaton, Rebecca and James, Martin and Janagan, Shalini and Johnson, Hilary and Karim, Areej and Khalid, Salema and Kinsey, Kath and Koduri, Gouri and Linton, Stuart and MacPhie, Elizabeth and Mahto, Arti and Mukhtyar, Chetan and Nandagudi, Anupama C and Nandi, Pradip and Osman, Fathelrahman and Plumb, Sophie and Quinlan, Eavan and Redfern, Angela and Regan, Marian and Reid, Vanessa and Roy, Dipak and Saeed, Sadaf and Smith, Abbey and Steel, Lauren and Thomas, Rhys and Ugwoke, Adaeze and Villar, Sarah and Williams, Emma and Wood, Fiona and Xie, Mingrui (2026) Coming to a hard stop? Effect of tapered tocilizumab after weekly tocilizumab cessation for GCA : a multicentre evaluation. Rheumatology, 65 (1): keaf450. ISSN 1462-0324
Full text not available from this repository.Abstract
Objectives In England, there is a ‘hard stop’ to weekly tocilizumab (qwTCZ) therapy for GCA; this is currently 12 months but was extended during the COVID-19 pandemic subject to certain criteria for GCA relapse risk. Taking advantage of variation in practice, we aimed to compare outcomes of GCA patients who tapered-TCZ vs those who stopped abruptly (non-taper patients). Methods Secondary analysis of an English multicentre service evaluation of relapse after stopping qwTCZ for GCA. Time to relapse was compared between taper and non-taper patients. We examined outcomes according to whether they had been ‘adequate responders’ during qwTCZ therapy, defined as those in remission and on ≤5 mg prednisolone at qwTCZ cessation, without relapse whilst taking qwTCZ. Results We analysed 336 patients from 40 centres. Time to relapse after qwTCZ cessation was significantly longer in adequate responders than non-adequate responders (P = 0.0004). 17.0% (57/336) patients tapered to fortnightly TCZ after qwTCZ cessation, for a median of 6 (IQR 2–13) months. For adequate responders, time to relapse whilst taking tapered-dose TCZ was significantly longer compared with those in the non-taper group (P = 0.0231) based on a relatively small number of flares. There was no difference between the taper and non-tapered groups after tapered-TCZ was stopped (P = 0.8346). In contrast, time to relapse for non-adequate responders was similar in taper patients compared with non-taper patients (P = 0.4892). Conclusion Tapering TCZ after qwTCZ cessation delayed relapse only during the tapering period, but only in adequate responders to qwTCZ. No lasting benefit was seen after tapering ended.