Treatment efficacy and safety of adalimumab versus tocilizumab in patients with active and severe Takayasu arteritis: an open-label study

Objective: This study aimed to compare the efficacy and safety of adalimumab (ADA) vs tocilizumab (TCZ) in patients with Takayasu arteritis (TAK). Methods: This was a randomized, controlled, open-label study. Forty patients with active and severe TAK were enrolled. They were treated with ADA (n=21) combined with glucocorticoids (GCs) and MTX or TCZ (n=19) combined with GCs and MTX. The planned follow-up duration was 12months. The primary end point was the efficacy rate (ER) at 6 months. The secondary end points included ER at 9 and 12 months, relapse rate, GC tapering, adverse effects, and life quality changes during treatment. Results: In the intention-to-treat (ITT) population, the ER at 6 months was higher in the ADA group (85.71% vs 52.63%, P=0.02). A similar direction of effect was noted in the per-protocol set (89.47% vs 62.50%, P=0.06). The percentages of patients who achieved a GC dose of <= 10mg/day at 6 months were similar between the ADA and TCZ groups (47.37% vs 43.75%, P=0.83). The ERs at 9 and 12 months were similar between the two groups (P>0.05). During the first 12 months of treatment, the relapse rate and adverse event incidence were comparable between the two groups (ADA vs TCZ: 9.52% vs 10.53%, P=0.96; 38.10% vs 47.37%, P=0.55, respectively). Conclusion: ADA combined with GCs and MTX may be more efficacious than TCZ combined with GCs and MTX among patients with active and severe TAK.