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

被引：21

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