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Scientific Abstracts
Poster View
Vasculitis - large vessel vasculitis
POS0714 TREAT-TO-TARGET RECOMMENDATIONS IN GIANT CELL ARTERITIS AND POLYMYALGIA RHEUMATICA
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  1. C. Dejaco1,2,
  2. A. Kerschbaumer3,
  3. D. Aletaha3,
  4. M. Bond1,
  5. E. Hysa4,
  6. D. Camellino5,
  7. L. Ehlers6,
  8. A. Abril7,
  9. S. Appenzeller8,
  10. M. C. Cid9,10,
  11. B. Dasgupta11,
  12. C. Duftner12,
  13. P. Grayson13,
  14. B. Hellmich14,
  15. A. Hocevar15,
  16. T. Kermani16,
  17. E. Matteson17,
  18. S. Mollan18,
  19. L. Neill19,
  20. C. Ponte20,21,
  21. C. Salvarani22,
  22. S. E. Sattui23,
  23. W. A. Schmidt24,
  24. P. Seo25,
  25. J. Smolen3,
  26. J. Thiel2,26,
  27. C. Toro Gutiérrez27,
  28. M. Whitlock11,
  29. F. Buttgereit6
  1. 1Ospedale di Brunico, Rheumatology, Brunico, Italy
  2. 2Medical University of Graz, Rheumatology and Immunology, Graz, Austria
  3. 3Medical University of Vienna, Rheumatology, Wien, Austria
  4. 4IRCCS AOU San Martino, Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, Genova, Italy
  5. 5Local Health Trust 3, Rheumatology, Genova, Italy
  6. 6Charité – Universitätsmedizin Berlin, Rheumatology, Berlin, Germany
  7. 7Mayo Clinic, Rheumatology, Jacksonville, United States of America
  8. 8UNICAMP Universidade Estadual de Campinas, Orthopedics, Rheumatology and Traumatology, Campinas, Brazil
  9. 9Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), -, Barcelona, Spain
  10. 10University of Barcelona, Autoimmune Diseases, Hospital Clinic, Barcelona, Spain
  11. 11Southend University Hospital NHS Foundation Trust, Rheumatology, Southend-on-Sea, United Kingdom
  12. 12Medizinische Universität Innsbruck, Internal Medicine, Clinical Division of Internal Medicine II, Innsbruck, Austria
  13. 13National Institute of Arthritis and Musculoskeletal and Skin Diseases, Systemic Autoimmunity Branch, Bethesda, United States of America
  14. 14medius KLINIK Kirchheim, Internal Medicine, Rheumatology and Immunology, Kirchheim unter Teck, Germany
  15. 15University Medical Center Ljubljana, Rheumatology, Ljubljana, Slovenia
  16. 16University of California, Los Angeles, Rheumatology, Los Angeles, United States of America
  17. 17Mayo Clinic College of Medicine and Science, Rheumatology, Rochester, United States of America
  18. 18Queen Elizabeth Hospital Birmingham, Neuro-ophthalmology, Birmingham, United Kingdom
  19. 19PMR-GCA Scotland, -, Dundee, United Kingdom
  20. 20Hospital de Santa Maria, Rheumatology, Lisboa, Portugal
  21. 21University of Lisbon, Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Lisboa, Portugal
  22. 22University of Modena and Reggio Emilia, Rheumatology, Modena, Italy
  23. 23University of Pittsburgh School of Medicine, Rheumatology and Clinical Immunology, Pittsburgh, United States of America
  24. 24Immanuel Hospital Berlin Buch, Medical Centre for Rheumatology, Berlin, Germany
  25. 25Johns Hopkins University, Rheumatology, Baltimore, United States of America
  26. 26University Hospital Freiburg, Internal Medicine, Clinic for Rheumatology and Clinical Immunology, Freiburg im Breisgau, Germany
  27. 27Pontificia Universidad Javeriana - Cali, Reference Center in Osteoporosis, Rheumatology & Dermatolog, Cali, Colombia

Abstract

Background The treat-to-target (T2T) concept is not yet a recognized treatment approach in giant cell arteritis (GCA) and polymyalgia rheumatica (PMR). Developing such recommendations is an unmet medical need.

Objectives To determine therapeutic targets and develop treat-to-target (T2T) recommendations in GCA and PMR.

Methods We conducted a systematic literature review to retrieve data on treatment targets and outcomes in GCA/PMR as well as to identify the evidence for the effectiveness of T2T-based management approaches in these diseases. Based on evidence and expert opinion, the task force [29 participants from 10 countries (physicians, healthcare professional and patient)] developed recommendations, with consensus obtained through voting. The final level of agreement was provided anonymously.

Results Five overarching principles and six specific recommendations were formulated (Table 1). Key messages are that the management of GCA and PMR should be based on shared decisions between patient and physician, underpinning the need for urgent treatment of GCA to avoid ischemic complications, and that it should aim at maximizing health-related quality of life in both diseases. The treatment targets are the achievement and maintenance of remission (still in need of ultimate validation), as well as prevention of tissue ischemia and vascular damage. Comorbidities should be considered when assessing disease activity and selecting treatment.

Conclusion These are the first T2T recommendations for GCA and PMR. Treatment targets and strategies to assess, achieve and maintain these targets have been defined. The research agenda highlights the evidence-gaps and needs for future research.

View this table:
Table 1.

Treat-to-Target (T2T) recommendations in GCA and PMR

Acknowledgements Funding to conduct this project has been provided by AbbVie.

The authors would like to thank Louise Falzon for her work in the development of the literature search strategy.

Disclosure of Interests Christian Dejaco Speakers bureau: Abbvie, Eli Lilly, Janssen, Novartis, Pfizer, Roche, Galapagos and Sanofi, Consultant of: Abbvie, Eli Lilly, Janssen, Novartis, Pfizer, Roche, Galapagos, Sparrow and Sanofi, Grant/research support from: AbbVie, Andreas Kerschbaumer Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Eli Lilly, Gilead, Janssen, Merck Sharp and Dohme, Novartis, UCB and Pfizer, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Eli Lilly, Gilead, Janssen, Merck Sharp and Dohme, Novartis, UCB and Pfizer, Daniel Aletaha Speakers bureau: Abbvie, Amgen, Galapagos, Lilly, Janssen, Merck, Novartis, Pfizer, Sandoz, and Sanofi, Consultant of: Abbvie, Amgen, Galapagos, Lilly, Janssen, Merck, Novartis, Pfizer, Sandoz, and Sanofi, Grant/research support from: Abbvie, Amgen, Galapagos, Lilly, Janssen, Merck, Novartis, Pfizer, Sandoz, and Sanofi, Milena Bond: None declared, Elvis Hysa: None declared, Dario Camellino Speakers bureau: Abiogen, BMS and GSK, Lisa Ehlers: None declared, Andy Abril: None declared, Simone Appenzeller: None declared, Maria C. Cid Speakers bureau: GSK and SCL-Vifor, Consultant of: GSK, Vifor, Abbvie, and Janssen, Grant/research support from: Kiniksa Pharmaceuticals, Bhaskar Dasgupta Speakers bureau: Chugai, Consultant of: Novartis, Abbvie, Roche, Christina Duftner Speakers bureau: Abbvie, AOP Orphan, Astra-Zeneca, Bristol-Myers-Squibb, Eli-Lilly, Janssen, Galapagos, Merck-Sharp-Dohme, Novartis, Pfizer, Roche, Sandoz, UCB, Vifor, Consultant of: Abbvie, AOP Orphan, Astra-Zeneca, Bristol-Myers-Squibb, Eli-Lilly, Janssen, Galapagos, Merck-Sharp-Dohme, Novartis, Pfizer, Roche, Sandoz, UCB, Vifor, Grant/research support from: Eli-Lilly, Pfizer, UCB, Peter Grayson: None declared, Bernhard Hellmich Speakers bureau: Abbvie, Amgen, Astra-Zeneca, BMS, Boehringer, Chugai, GSK, InflaRx, Janssen, MSD, Pfizer, Novartis, Phadia, Roche and Vifor, Consultant of: Abbvie, Amgen, Astra-Zeneca, BMS, Boehringer, Chugai, GSK, InflaRx, Janssen, MSD, Pfizer, Novartis, Phadia, Roche and Vifor, ALOJZIJA HOCEVAR: None declared, Tanaz Kermani: None declared, Eric Matteson Speakers bureau: Boehringer-Ingelheim, Consultant of: Boehringer-Ingelheim, Horizon Therapeutics, Alvotech Inc, Susan Mollan Speakers bureau: Heidelberg engineering; Chugai-Roche Ltd; Allergan; Santen; Teva UK; Chiesi; and Santhera, Consultant of: Invex Therapeutics, Gensight, Lorna Neill: None declared, Cristina Ponte Speakers bureau: Vifor, AstraZeneca, GlaxoSmithKline, and Roche, Consultant of: Vifor, AstraZeneca, GlaxoSmithKline, and Roche, Grant/research support from: AbbVie, Sanofi and Novartis, Carlo Salvarani Speakers bureau: Abbvie, Boehringer-Ingelheim, Eli Lilly, Galapagos, Novartis, Pfizer and Roche, Consultant of: Abbvie, Boehringer-Ingelheim, Eli Lilly, Galapagos, Novartis, Pfizer and Roche, Sebastian E. Sattui Grant/research support from: Astra-Zeneca, Rheumatology Research Foundation RISE pilot award and Bristol Myers Squibb Foundation Robert A. Winn Diversity in Clinical Trials Career Development Award, Wolfgang A. Schmidt Speakers bureau: Abbvie, Amgen, Bristol-Myers Squibb, Chugai, GlaxoSmithKline, Johnson & Johnson, Medac, Novartis, Roche, and Sanofi, Consultant of: Abbvie, Amgen, Bristol-Myers Squibb, Chugai, GlaxoSmithKline, Johnson & Johnson, Medac, Novartis, Roche, and Sanofi, Grant/research support from: Abbvie, Amgen, GlaxoSmithKline, Novartis, Roche and Sanofi, Philip Seo Consultant of: Amgen and Janssen, Josef Smolen Speakers bureau: AbbVie, Amgen, AstraZeneca, Astro, Bristol-Myers Squibb, Celltrion, Chugai, Gilead, Janssen, Lilly, Merck Sharp & Dohme, Novartis-Sandoz, Pfizer, R-Pharm, Roche, Samsung, Sanofi, and UCB, Consultant of: AbbVie, Amgen, AstraZeneca, Astro, Bristol-Myers Squibb, Celltrion, Chugai, Gilead, Janssen, Lilly, Merck Sharp & Dohme, Novartis-Sandoz, Pfizer, R-Pharm, Roche, Samsung, Sanofi, and UCB, Grant/research support from: Abbvie, AstraZeneca, Lilly, Novartis and Roche, Jens Thiel Speakers bureau: Bristol-Myers-Squibb, Novartis, Glaxo-Smith-Kline, Astra-Zeneca, Janssen, Abbvie, Eli-Lilly, Consultant of: Bristol-Myers-Squibb, Novartis, Glaxo-Smith-Kline, Astra-Zeneca, Janssen, Abbvie, Eli-Lilly, CARLOS TORO GUTIÉRREZ Speakers bureau: Abbvie, BMS, Boehringer Ingelheim, Biopas, Janssen, Pfizer, Pharmalab, Roche, Consultant of: Abbvie, BMS, Boehringer Ingelheim, Biopas, Janssen, Pfizer, Pharmalab, Roche, Madeline Whitlock Speakers bureau: Roche, Frank Buttgereit Speakers bureau: Abbvie, Novartis, Pfizer, Roche, and Sanofi, Consultant of: Abbvie, Novartis, Pfizer, Roche, and Sanofi.

  • Vasculitis
  • Remission
  • Treat to target

https://doi.org/10.1136/annrheumdis-2023-eular.254

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