Biotherapies in large vessel vasculitis

被引:50
作者
Ferfar, Y. [1 ]
Mirault, T. [2 ]
Desbois, A. C. [1 ]
Comarmond, C. [1 ]
Messas, E. [2 ]
Savey, L. [1 ]
Domont, F. [1 ]
Cacoub, P. [1 ]
Saadoun, D. [1 ]
机构
[1] Univ Paris 06, Grp Hosp Pitie Salpetriere, AP HP,Serv Med Interne & Immunol Clin,DHU I2B, Ctr Reference Malad Autoimmunes & Syst Rares,Immu, Paris, France
[2] Grp Hosp HEGP, AP HP, Serv Med Vasc, Ctr Natl Reference Malad Vasc Rares, Paris, France
关键词
Giant cell arteritis; Takayasu; Behcet's disease; Relapsing polychondritis; Biotherapy; GIANT-CELL ARTERITIS; REFRACTORY TAKAYASU ARTERITIS; PLACEBO-CONTROLLED TRIAL; NECROSIS FACTOR THERAPY; ANTI-TNF-ALPHA; RELAPSING POLYCHONDRITIS; BEHCETS-DISEASE; POLYMYALGIA-RHEUMATICA; EULAR RECOMMENDATIONS; SUSTAINED RESPONSE;
D O I
10.1016/j.autrev.2016.02.012
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Giant cell arteritis (GCA) and Takayasu's arteritis (TA) are large vessel vasculitis (LW) and aortic involvement is not uncommon in Behcet's disease (BD) and relapsing polychondritis (RP). Glucocorticosteroids are the mainstay of therapy in LW. However, a significant proportion of patients have glucocorticoid dependance, serious side effects or refractory disease to steroids and other immunosuppressive treatments such as cyclophosphamide, azathioprine, mycophenolate mofetil and methotrexate. Recent advances in the understanding of the pathogenesis have resulted in the use of biological agents in patients with LW. Anti-tumor necrosis factor-alpha drugs seem effective in patients with refractory Takayasu arteritis and vascular BD but have failed to do so in giant cell arteritis. Preliminary reports on the use of the anti-IL6-receptor antibody (tocilizumab), in LW have been encouraging. The development of new biologic targeted therapies will probably open a promising future for patients with LW. (C) 2016 Elsevier B.V. All rights reserved.
引用
收藏
页码:544 / 551
页数:8
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