Real-world effectiveness and safety of secukinumab (IL-17A inhibitor) in 36 GCA patients at 14 Italian centres, most with relapsing disease and prior tocilizumab exposure, followed for at least 6 months.
Clinical remission was achieved in ~83% at 12 months; GC-free remission rose progressively to 40% at 12 months (p=0.012); median daily GC dose fell from 8.7 mg to 0 mg (p<0.001); 12-month drug retention was 77%. Adverse events occurred in 56%, with infections in 50% of patients.
Small sample (n=36), retrospective design, no control arm, and most patients were heavily pre-treated (89% relapsers, 72% prior tocilizumab), limiting generalizability; the phase III GCAptAIN trial did not meet its primary endpoint.
In refractory or relapsing GCA patients who have failed tocilizumab, secukinumab may offer meaningful remission and steroid-sparing benefits, but the high infection rate (50%) warrants close monitoring; consider it a salvage option pending further trial data.
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