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Table 2 Eligibility criteria (selection)

From: Efficacy and safety of secukinumab in patients with giant cell arteritis: study protocol for a randomized, parallel group, double-blind, placebo-controlled phase II trial

Inclusion criteria

Exclusion criteria

â–º Diagnosis of GCA classified according to the following criteria:

• Age at onset of disease ≥ 50 years.

• History of ESR ≥ 30 mm/h or CRP ≥ 10 mg/L.

• Unequivocal cranial symptoms of GCA (new-onset localized headache, scalp or temporal artery tenderness, ischemia-related vision loss, or otherwise unexplained mouth of jaw pain upon mastication) AND/OR symptoms of PMR (defined as shoulder and/or hip girdle pain associated with inflammatory morning stiffness).

• Temporal artery biopsy revealing features of GCA AND/OR evidence of large-vessel vasculitis by angiography or cross-sectional imaging study such as MRA, positron emission tomography-computed tomography (PET-CT), or ultrasound.

â–º Patients with new onset GCA or relapsing GCA:

• Definition of new onset: diagnosis of GCA within 6 weeks prior to baseline visit.

• Definition of relapsing GCA: diagnosis of GCA (in accordance with inclusion criterion no. 4) > 6 weeks prior to baseline visit and in the meantime achieved remission (absence of signs and symptoms attributable to GCA and normalization of ESR [< 30 mm/h] and CRP [< 10 mg/L]) including previous treatment with ≥ 25 mg/day prednisolone equivalent for ≥ 2 weeks.

► Active disease as defined by the presence of signs and symptoms of GCA (cranial or PMR) and elevated ESR ≥ 30 mm/h, or CRP ≥ 10 mg/L, attributed to active GCA within 6 weeks of baseline.

► Prednisolone dose of 25–60 mg/day at baseline.

â–º Previous exposure to secukinumab or other biologic drug directly targeting IL-17 or IL17 receptor.

â–º Patients treated with any cell-depleting therapies including but not limited to anti-CD20 of investigational agents (e.g., anti-CD3, anti-CD4, anti-CD5 or anti-CD19).

â–º Patients who have previously been treated with any biologic agent including but not limited to tocilizumab, sirukinumab, abatacept, or TNF-alpha inhibitors (infliximab, adalimumab, etanercept, certolizumab, golimumab).

â–º Patients who have previously been treated with tofacitinib or baricitinib.

â–º Patients treated with intravenous immunoglobulins or plasmapheresis within 8 weeks prior to baseline.

â–º Patients treated with cyclophosphamide, tacrolimus or everolimus with 6 months prior to baseline.

â–º Patients treated with hydrochloroquine, cyclosporine A, azathioprine, sulfasalazine, mycophenolate mofetil within 4 weeks of baseline.

â–º Patients treated with leflunomide within 8 weeks of baseline unless a cholestyramine washout has been performed in which case the patient must be treated within 4 weeks of baseline.

â–º Patients treated with an alkylating agent.

â–º Patients requiring systemic chronic glucocorticoid therapy for any other reason than GCA.

â–º Chronic systemic glucocorticoid therapy over the last 4 years or longer, or inability, in the opinion of the investigator, to withdraw glucocorticoid therapy through protocol-defined taper regimen due to suspected or established adrenal insufficiency.

â–º Patients requiring chronic high potency opioid analgesics for pain management.

â–º Active ongoing inflammatory diseases or underlying metabolic, hematologic, renal, hepatic, pulmonary, neurologic, endocrine, cardiac, infectious or gastrointestinal conditions, which in the opinion of the investigator immunocompromises the patients and/or places the patients at unacceptable risk for participation in an immunomodulatory therapy.

► History of renal trauma, glomerulonephritis, or patients with one kidney only, or a serum creatinine level exceeding 1.8 mg/dL (159.12 μmol/L).

► Screening total white blood cell count < 3000/μl, or platelets < 100 000/μl, or neutrophils < 1500/μl, or hemoglobin < 8.3 g/dL (83 g/L).

â–º Major ischemic event, unrelated to GCA, with 12 weeks of screening.

â–º Known infection with human immunodeficiency virus, hepatitis B or hepatitis C at screening or randomization.

â–º Life vaccination within 6 weeks prior to baseline or planned vaccination during the study participation until 12 weeks after last study treatment administration.