Translational study findings have corroborated the role of granulocyte-macrophage colony-stimulating factor (GM-CSF) in upregulating TH1/TH17 pathways and pathogenesis in temporal arteries of patients with giant cell arteritis. A recent study published in the journal Clinical Science has concluded on the efficacy of mavrilimumab in combination with 26-week prednisone in reducing the risk of flare and sustaining the remission in giant cell arteritis.
Studies have reported several disadvantages of the currently available treatment for giant cell
arteritis. Disease relapse and/or development of glucocorticoid-related toxicity were noted in the majority of the subjects with giant cell arteritis treated with glucocorticoids. Moreover, most of the patients treated with tocilizumab could not attain sustained remission or discontinued the treatment due to adverse effects.
The phase 2, double-blind, placebo-controlled was carried out in patients with biopsy-confirmed or imaging-confirmed giant cell arteritis across 50 centers in North America, Europe, and Australia. During the study, patients in glucocorticoid-induced remission were administered subcutaneously with mavrilimumab 150 mg or every 2 weeks. Both the arms also received a 26-week, tapering dose of prednisone. Disease flare was noted only in 19% of the mavrilimumab recipients and 46% of the placebo recipients. The median time to flare noted in the placebo group was 25.1, whereas the mavrilimumab group did not attain the
median (HR 0.38; 95% CI 0.15 to 0.92; p=0.026). The corresponding sustained remission noted in mavrilimumab and placebo arms at week 26 were 83% and 50% (p=0.0038). The rate of adverse events noted in the corresponding groups was 78.6% and 89.3%.
The present study findings demonstrate the potential of mavrilimumab in maintaining remission by blocking the GM-CSF receptor. In addition, the study opens up a venue for research for developing mavrilimumab as a potential therapeutic agent for giant cell arteritis.
References: Cid MC, Unizony SH, Blockmans D, et al. Efficacy and safety of mavrilimumab in giant cell arteritis: a phase 2, randomized, double-blind, placebo-controlled trial [published online ahead of print, 2022 Mar 9]. Ann Rheum Dis. 2022; annrheumdis-2021-221865.