RT Journal Article
T1 Tocilizumab in refractory Caucasian Takayasu's arteritis: a multicenter study of 54 patients and literature review.
A1 Prieto-Peña, Diana
A1 Bernabeu, Pilar
A1 Vela, Paloma
A1 Narváez, Javier
A1 Fernández-López, Jesús C
A1 Freire-González, Mercedes
A1 González-Álvarez, Beatriz
A1 Solans-Laqué, Roser
A1 Callejas Rubio, José L
A1 Ortego, Norberto
A1 Fernández-Díaz, Carlos
A1 Rubio, Esteban
A1 García-Morillo, Salvador
A1 Minguez, Mauricio
A1 Fernández-Carballido, Cristina
A1 de Miguel, Eugenio
A1 Melchor, Sheila
A1 Salgado, Eva
A1 Bravo, Beatriz
A1 Romero-Yuste, Susana
A1 Salvatierra, Juan
A1 Hidalgo, Cristina
A1 Manrique, Sara
A1 Romero-Gómez, Carlos
A1 Moya, Patricia
A1 Álvarez-Rivas, Noelia
A1 Mendizabal, Javier
A1 Ortiz-Sanjuán, Francisco
A1 Pérez de Pedro, Iván
A1 Alonso-Valdivielso, José L
A1 Perez-Sanchez, Laura
A1 Roldán, Rosa
A1 Fernandez-Llanio, Nagore
A1 Gómez de la Torre, Ricardo
A1 Suarez, Silvia
A1 Montesa Cabrera, María Jesús
A1 Delgado Sánchez, Mónica
A1 Loricera, Javier
A1 Atienza-Mateo, Belén
A1 Castañeda, Santos
A1 González-Gay, Miguel A
A1 Blanco, Ricardo
K1 Caucasian
K1 Takayasu’s arteritis
K1 Tocilizumab
K1 biological therapy
K1 cDMARDs
AB To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu's arteritis (TAK) in clinical practice. 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 (TCZMONO) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZCOMBO) was performed. 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 TCZMONO and 31 (57.4%) on TCZCOMBO: MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). Patients on TCZCOMBO 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. TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin.
SN 1759-720X
YR 2021
FD 2021-06-18
LK https://hdl.handle.net/10668/26499
UL https://hdl.handle.net/10668/26499
LA en
DS RISalud
RD Apr 7, 2025