Full Papers
Tocilizumab in patients with Takayasu arteritis: a retrospective study and literature review
J. Loricera1, R. Blanco2, J.L. Hernández3, S. Castañeda4, A. Humbría5, N. Ortego6, B. Bravo7, M. Freire8, S. Melchor9, M. Mínguez10, J. Salvatierra11, C. González-Vela12, V. Calvo-Río13, M. Santos-Gómez14, T. Pina15, M.A. González-Gay16
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
- Department of Rheumatology, Hospital Universitario La Princesa, IIS-Princesa, Madrid, Spain.
- Department of Rheumatology, Hospital Universitario La Princesa, IIS-Princesa, Madrid, Spain.
- Department of Autoimmune Diseases, Hospital San Cecilio, Granada, Spain.
- Unit of Paediatric Rheumatology, Hospital Virgen de las Nieves, Granada, Spain.
- Department of Rheumatology, Complexo Hospitalario A Coruña (CHUAC), Spain.
- Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain.
- Department of Rheumatology, Hospital Universitario San Juan, Alicante, Spain.
- Department of Autoimmune Diseases, Hospital San Cecilio, Granada, Spain.
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain. miguelaggay@hotmail.com
CER8694
2016 Vol.34, N°3 ,Suppl.97
PI 0044, PF 0053
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PMID: 27050507 [PubMed]
Received: 15/06/2015
Accepted : 07/10/2015
In Press: 06/04/2016
Published: 27/05/2016
Abstract
OBJECTIVES:
To assess the efficacy of tocilizumab (TCZ) in patients with Takayasu arteritis (TA).
METHODS:
Multicentre open-label retrospective study.
RESULTS:
Eight patients (all women) with a mean age of 34±16 years, median 36 years (range: 7-57) were assessed. The main clinical features at TCZ therapy onset were: constitutional symptoms (n=4), fever (n=3), headache (n=2), chest pain (n=1), abdominal pain (n=1), mesenteric ischaemia (n=1), myalgia involving the lower limbs (n=1), cerebral vascular insufficiency (n=1), malaise (n=1), upper limb claudication (n=1) and nodular scleritis (n=1). Besides corticosteroids and before TCZ treatment onset, 7 of 8 patients had also received several conventional immunosuppressive and/or biologic agents. Seven patients experienced marked clinical improvement in the first 3 months after the onset of TCZ therapy. After a median follow-up of 15.5 [interquartile range-IQR: 12-24] months, 7 patients were asymptomatic. The median C-reactive protein decreased from 3.09 [IQR: 0.5-12] to 0.15 [IQR: 0.1-0.5] mg/dL (p=0.018), and median erythrocyte sedimentation rate from 40 [IQ range: 28-72] to 3 [IQR: 2–5] mm/1st hour (p=0.012). The median dose of prednisone was also tapered from 42.5 [IQR: 25-50] to 2.5 [IQR: 0-7.5] mg/day (p=0.011). However, TCZ had to be discontinued in 1 patient because she developed a systemic lupus erythematosus, and in another patient due to inefficiency. TCZ dose was reduced in a patient because of mild thrombocytopenia.
CONCLUSIONS:
TCZ appears to be effective in the management of patients with TA, in particular in patients refractory to corticosteroids and/or conventional immunosuppressive drugs.
