Biologic treatments in Takayasu's Arteritis: A comparative study of tumor necrosis factor inhibitors and tocilizumab

被引：19

作者：

Alibaz-Oner, Fatma ^{[1
]}

Kaymaz-Tahra, Sema ^{[2
]}

Bayindir, Ozun ^{[3
]}

Yazici, Ayten ^{[4
]}

Ince, Burak ^{[5
]}

Kalkan, Kubra ^{[6
]}

Kanitez, Nilufer Alpay ^{[7
]}

Kocaer, Sinem Burcu ^{[8
]}

Bilge, Nazife Sule Yasar ^{[9
]}

Omma, Ahmet ^{[10
]}

Durak, Elif ^{[11
]}

Ilgin, Can ^{[12
]}

Akar, Servet ^{[11
]}

Kasifoglu, Timucin ^{[9
]}

Onen, Fatos ^{[8
]}

Emmungil, Hakan ^{[6
]}

Inanc, Murat ^{[5
]}

Cefle, Ayse ^{[4
]}

Aksu, Kenan ^{[3
]}

Keser, Gokhan ^{[3
]}

Direskeneli, Haner ^{[1
]}

机构：

[1] Marmara Univ, Sch Med, Dept Internal Med, Div Rheumatol, Istanbul, Turkey

[2] Sancaktepe Prof Dr Ilhan Varank Training & Res Ho, Rheumatol, Istanbul, Turkey

[3] Ege Univ, Dept Internal Med, Div Rheumatol, Sch Med, Izmir, Turkey

[4] Kocaeli Univ, Dept Internal Med, Div Rheumatol, Sch Med, Istanbul, Turkey

[5] Istanbul Univ, Dept Internal Med Rheumatol, Istanbul Fac Med, Istanbul, Turkey

[6] Trakya Univ, Dept Internal Med, Div Rheumatol, Sch Med, Edirne, Turkey

[7] Koc Univ, Dept Internal Med, Div Rheumatol, Sch Med, Istanbul, Turkey

[8] Dokuz Eylul Univ, Dept Internal Med, Div Rheumatol, Sch Med, Izmir, Turkey

[9] Osmangazi Univ, Dept Internal Med, Div Rheumatol, Sch Med, Eskisehir, Turkey

[10] Ankara City Hosp, Rheumatol, Minist Hlth, Ankara, Turkey

[11] Katip Celebi Univ, Dept Internal Med, Div Rheumatol, Sch Med, Izmir, Turkey

[12] Marmara Univ, Dept Publ Hlth, Fac Med, Istanbul, Turkey

来源：

SEMINARS IN ARTHRITIS AND RHEUMATISM | 2021年 / 51卷 / 06期

关键词：

Takayasu arteritis; Biologic treatment; Tocilizumab; TNF inhibitor; Drug survival; FACTOR THERAPY; DOUBLE-BLIND; EFFICACY; MANAGEMENT; TRIAL;

D O I：

10.1016/j.semarthrit.2021.09.010

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: To compare the treatment outcomes of TNF inhibitors and tocilizumab (TCZ) in patients with Takayasu arteritis. Methods: Takayasu arteritis patients who were refractory to conventional immunosuppressive (IS) drugs and received biologic treatment were included in this multicenter retrospective cohort study. Clinical, laboratory and imaging data during follow-up were recorded. Remission, glucocorticoid (GC) sparing effect, drug survival was compared between TNF inhibitor and TCZ treatments. Also, a subgroup matched comparison was performed between groups. Results: One hundred and eleven (F/M: 98/13) patients were enrolled. A total of 173 biologic treatment courses (77 infliximab, 49 TCZ, 33 adalimumab, 9 certolizumab, 3 rituximab, 1 ustekinumab and 1 anakinra) were given. Tocilizumab was chosen in 23 patients and TNF inhibitors were chosen in 88 patients as first line biologic agent. Complete/partial remission rates between TCZ and TNF inhibitors were similar at 3rd month and at the end of the follow-up. GC dose decrease (<4 mg) or discontinuation of GCs was achieved in a similar rate in both groups (TNF inhibitors vs TCZ: 78% vs 59%, p = 0.125). Drug survival rate was 56% in TNF inhibitors and 57% in TCZ group (p = 0.22). The use of concomitant conventional ISs did not affect the drug survival (HR =0.78, 95% CI =0.42-1.43, p = 0.42). The match analysis showed similar results between groups in terms of relapse, decrease in GC dose, surgery need and mortality. Conclusion: The efficacy and safety outcomes and drug survival rates seem to be similar for TNF inhibitors and tocilizumab in patients with Takayasu arteritis. (c) 2021 Elsevier Inc. All rights reserved.

引用

页码：1224 / 1229

页数：6