TNF Blockers No Help in New-Onset Giant Cell Arteritis

Despite the need for treatment, these patients declined steroid therapy because of their comorbidities, according to Dr. Nannini.

They did, however, consent to treatment with adalimumab (40 mg) every 2 weeks.

After 1 month of therapy, all three were in remission, with ESRs less than 20 mm/hour, CRPs less than 0.5 mg/dL, and no remaining musculoskeletal, cranial, or systemic symptoms.

After 6 months, the adalimumab dosage was reduced to 40 mg once monthly; after 12 months of therapy, the drug was discontinued in two of the three patients. They remain in remission 4 and 5 months later, whereas the third patient is completing 1 year of treatment with good response.

“Comorbidities such as diabetes, hypertension, and osteoporosis are very common among patients with GCA, highlighting the need for corticosteroid-sparing agents. … Our limited experience with adalimumab suggests that the drug may represent an effective alternative to corticosteroids in patients with GCA who had corticosteroid dose-limiting comorbidities,” she concluded.

Dr. Pipitone described these findings with adalimumab as “quite intriguing.” He added, however, “I don't think we can make a case for the use of TNF blockers in clinical practice, at least not at this stage.”

Neither Dr. Pipitone nor Dr. Nannini reported conflicts of interest.