Tocilizumab in refractory Caucasian Takayasu's arteritis: a multicenter study of 54 patients and literature review

被引：18

作者：

Prieto-Pena, Diana ^{[4
]}

Bernabeu, Pilar ^{[5
]}

Vela, Paloma ^{[5
]}

Narvaez, Javier ^{[6
]}

Fernandez-Lopez, Jesus C. ^{[7
]}

Freire-Gonzalez, Mercedes ^{[7
]}

Gonzalez-Alvarez, Beatriz ^{[8
]}

Solans-Laque, Roser ^{[9
]}

Callejas Rubio, Jose L. ^{[10
]}

Ortego, Norberto ^{[10
]}

Fernandez-Diaz, Carlos ^{[11
]}

Rubio, Esteban ^{[12
]}

Garcia-Morillo, Salvador ^{[12
]}

Minguez, Mauricio ^{[13
]}

Fernandez-Carballido, Cristina ^{[13
]}

de Miguel, Eugenio ^{[14
]}

Melchor, Sheila ^{[15
]}

Salgado, Eva ^{[16
]}

Bravo, Beatriz ^{[17
]}

Romero-Yuste, Susana ^{[18
]}

Salvatierra, Juan ^{[10
]}

Hidalgo, Cristina ^{[19
]}

Manrique, Sara ^{[20
]}

Romero-Gomez, Carlos ^{[20
]}

Moya, Patricia ^{[21
]}

Alvarez-Rivas, Noelia ^{[22
]}

Mendizabal, Javier ^{[23
]}

Ortiz-Sanjuan, Francisco ^{[24
]}

Perez de Pedro, Ivan ^{[25
]}

Alonso-Valdivielso, Jose L. ^{[26
]}

Perez-Sanchez, Laura ^{[27
]}

Roldan, Rosa ^{[27
]}

Fernandez-Llanio, Nagore ^{[28
]}

Gomez de la Torre, Ricardo ^{[29
]}

Suarez, Silvia ^{[29
]}

Montesa Cabrera, Maria Jesus ^{[8
]}

Delgado Sanchez, Monica ^{[8
]}

Loricera, Javier ^{[4
]}

Atienza-Mateo, Belen ^{[4
]}

Castaneda, Santos ^{[11
,30
]}

Gonzalez-Gay, Miguel A. ^{[1
,2
,3
]}

Blanco, Ricardo ^{[4
]}

机构：

[1] Hosp Univ Marques de Valdecilla, Rheumatol Div, Res Grp Genet Epidemiol & Atherosclerosis Syst Di, IDIVAL, Ave Valdecilla S-N, Santander 39008, Spain

[2] Univ Cantabria, Sch Med, Santander, Spain

[3] Univ Witwatersrand, Fac Hlth Sci, Sch Physiol, Cardiovasc Pathophysiol & Genom Res Unit, Johannesburg, South Africa

[4] Hosp Univ Marques de Valdecilla, Dept Rheumatol, IDIVAL, Res Grp Genet Epidemiol & Atherosclerosis Syst Di, Santander, Spain

[5] Hosp Gen Alicante, Dept Rheumatol, Alicante, Spain

[6] Hosp Bellvitge Princeps Espanya, Dept Rheumatol, Barcelona, Spain

[7] Complejo Hosp Univ A Coruna, Dept Rheumatol, La Coruna, Spain

[8] Hosp Nuestra Senora Candelaria, Dept Rheumatol, Tenerife, Spain

[9] Hosp Valle De Hebron, Dept Internal Med, Barcelona, Spain

[10] Hosp San Cecilio, Autoimmune Dis Unit, Granada, Spain

[11] Hosp Univ Princesa, Dept Rheumatol, IIS Princesa, Madrid, Spain

[12] Hosp Virgen Rocio, Autoimmune Dis Unit, Seville, Spain

[13] Hosp San Juan Alicante, Dept Rheumatol, Alicante, Spain

[14] Hosp Univ La Paz, Dept Rheumatol, Madrid, Spain

[15] Hosp Univ 12 Octubre, Dept Rheumatol, Madrid, Spain

[16] Complejo Hosp Univ Ourense, Dept Rheumatol, Orense, Spain

[17] Hosp Virgen Nieves, Dept Rheumatol, Granada, Spain

[18] Complejo Hosp Univ Pontevedra, Dept Rheumatol, Pontevedra, Spain

[19] Complejo Univ Salamanca, Dept Rheumatol, Salamanca, Spain

[20] Hosp Reg Malaga, Autoimmune Dis Unit, Malaga, Spain

[21] Hosp Santa Creu & Sant Pau, Dept Rheumatol, Barcelona, Spain

[22] Hosp Univ San Agustin, Dept Rheumatol, Aviles, Spain

[23] Complejo Hosp Navarra, Dept Rheumatol, Pamplona, Spain

[24] Hosp Univ & Politecn La Fe, Dept Rheumatol, Valencia, Spain

[25] Hosp Carlos Haya, Autoimmune Dis Unit, Malaga, Spain

[26] Hosp Univ Burgos, Dept Rheumatol, Burgos, Spain

[27] Hosp Univ Reina Sofia, Dept Rheumatol, Cordoba, Spain

[28] Hosp Arnau Vilanova, Dept Rheumatol, Valencia, Spain

[29] Hosp Univ Cent Asturias, Autoimmune Dis Unit, Oviedo, Spain

[30] Univ Autonoma Madrid IUAMI, UAM ROCHE, EPID Future, Madrid, Spain

来源：

THERAPEUTIC ADVANCES IN MUSCULOSKELETAL DISEASE | 2021年 / 13卷

关键词：

biological therapy; Caucasian; cDMARDs; Takayasu's arteritis; Tocilizumab; DISEASE-ACTIVITY; EPIDEMIOLOGY; EFFICACY; FEATURES; CRITERIA; OUTCOMES; SAFETY; JAPAN;

D O I：

10.1177/1759720X211020917

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu's arteritis (TAK) in clinical practice. Methods: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZ(MONO)) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZ(COMBO)) was performed. Results: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5-50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0-31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5-50.0) to 5.0 (0.0-5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0-14.0) months. Twenty-three (42.6%) patients were on TCZ(MONO) and 31 (57.4%) on TCZ(COMBO): MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). Patients on TCZ(COMBO) were younger [38.0 (27.0-46.0) versus 45.0 (38.0-57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0-38.0) versus 6.0 (1.0-23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7-5.6) versus 1.3 (0.3-3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. Conclusion: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin.

引用

页数：12

共 50 条

[11] Systematic review and meta-analysis of the current literature on tocilizumab in patients with refractory Takayasu arteritis
Kang, Limei
Liu, Yang
Luo, Zhongling
Zhou, Yueyuan
Chen, Bo
Yin, Geng
Xie, Qibing
FRONTIERS IN IMMUNOLOGY, 2023, 14
[12] Efficacy of tocilizumab in Takayasu arteritis: Multicenter retrospective study of 46 patients
Mekinian, Arsene
Resche-Rigon, Mathieu
Comarmond, Cloe
Soriano, Alessandra
Constans, Joel
Alric, Laurent
Jego, Patrick
Busato, Florian
Cabon, Matthieu
Dhote, Robin
Estibaliz, Lazaro
Pault, Isabelle Kone
Landron, Cedric
Lavigne, Christian
Lioger, Bertrand
Michaud, Martin
Ruivard, Marc
Sacre, Karim
Gottenberg, Jacques Eric
Gaches, Francis
Goulenok, Tiphaine
Salvarani, Carlo
Cacoub, Patrice
Fain, Olivier
Saadoun, David
JOURNAL OF AUTOIMMUNITY, 2018, 91 : 55 - 60
[13] Efficacy and safety of tocilizumab in patients with refractory Takayasu arteritis
Lee, Young Ho
Song, Gwan Gyu
ANNALS OF THE RHEUMATIC DISEASES, 2019, 78 (01)
[14] EFFICACY OF TOCILIZUMAB IN TAKAYASU ARTERITIS: MULTICENTER FRENCH RETROSPECTIVE STUDY OF 46 PATIENTS
Mekinian, A.
Resche-Rigon, M.
Comarmond, C.
Soriano, A.
Constans, J.
Alric, P.
Jego, P.
Bussato, F.
Dhote, R.
Iazaro, E.
Pault, I. Kone
Landron, C.
Lavigne, C.
Lioger, B.
Michaud, M.
Ruivard, M.
Sacre, K.
Gottenberg, J. E.
Goulenok, T.
Salvarini, C.
Cacoub, P.
Fain, O.
Saadoun, D.
ANNALS OF THE RHEUMATIC DISEASES, 2018, 77 : 169 - 169
[15] TOCILIZUMAB IN REFRACTORY TAKAYASU ARTERITIS. OPEN-LABEL NATIONAL MULTICENTER STUDY OF 53 PATIENTS OF CLINICAL PRACTICE
Prieto-Pena, D.
Calderon-Goercke, M.
Bernabeu, P.
Vela-Casasempere, P.
Narvaez, J.
Fernandez-Lopez, C.
Freire Gonzalez, M.
Gonzalez-Alvarez, B.
Solans-Laque, R.
Callejas-Rubio, J. L.
Ortego, N.
Fernandez-Diaz, C.
Rubio Romero, E.
Garcia Morillo, S.
Minguez, M.
Fernandez-Carballido, C.
De Miguel, E.
Melchor, S.
Salgado-Perez, E.
Bravo, B.
Romero-Yuste, S.
Salvatierra, J.
Hidalgo, C.
Manrique Arija, S.
Romero-Gomez, C.
Moya, P.
Alvarez-Rivas, N.
Mendizabal, J.
Ortiz Sanjuan, F. M.
Perez de Pedro, I.
Loricera, J.
Castaneda, S.
Gonzalez-Gay, M. A.
Blanco, R.
ANNALS OF THE RHEUMATIC DISEASES, 2020, 79 : 1074 - 1075
[16] Tocilizumab in Refractory Takayasu's Arteritis: 7 Patients Followed At a Single Italian Centre
Tombetti, Enrico
Baldissera, Elena
Franchini, Stefano
Aiello, Patrizia
Motta, Francesca
Gulgielmi, Barbara
Sabbadini, Maria Grazia
ARTHRITIS AND RHEUMATISM, 2012, 64 (10): : S998 - S998
[17] Takayasu's arteritis: a review of the literature
Silvia Maffei
Michela Di Renzo
Giovanni Bova
Alberto Auteri
Anna Laura Pasqui
Internal and Emergency Medicine, 2006, 1 : 105 - 112
[18] Takayasu's arteritis: a review of the literature
Maffei, Silvia
Di Renzo, Michela
Bova, Giovanni
Auteri, Alberto
Pasqui, Anna Laura
INTERNAL AND EMERGENCY MEDICINE, 2006, 1 (02) : 105 - 112
[19] Effectiveness and safety of tocilizumab in patients with refractory or severe Takayasu's arteritis: A prospective cohort study in a Chinese population
Wu, Sifan
Kong, Xiufang
Cui, Xiaomeng
Chen, Huiyong
Ma, Lili
Dai, Xiaomin
Ji, Zongfei
Yan, Yan
Huang, Qingrong
Sun, Ying
Jiang, Lindi
JOINT BONE SPINE, 2021, 88 (05)
[20] Pregnancy outcome in patients with Takayasu's arteritis: cohort study and review of the literature
Kirshenbaum, Michal
Simchen, Michal J.
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE, 2018, 31 (21): : 2877 - 2883

← 1 2 3 4 5 →