Arsene Mekinian1, Cloé Comarmond1, Mathieu Resche-Rigon1, Tristan Mirault1, Jean Emmanuel Kahn1, Marc Lambert1, Jean Sibilia1, Antoine Néel1, Pascal Cohen1, Miguel Hie1, Sabine Berthier1, Isabelle Marie1, Christian Lavigne1, Marie Anne Vandenhende1, Géraldine Muller1, Zahir Amoura1, Hervé Devilliers1, Sébastien Abad1, Mohamed Hamidou1, Loïc Guillevin1, Robin Dhote1, Bertrand Godeau1, Emmanuel Messas1, Patrice Cacoub1, Olivier Fain1, David Saadoun1. 1. From AP-HP, Hôpital Saint Antoine, Service de Médecine Interne et Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France (A.M., O.F.); Service de Médecine Interne, Hôpital Pitié Salpetrière, Université Paris 6, Paris, France (C.C., P. Cacoub, D.S.); Unité Epidémiologie et Biostatistiques, INSERM, Hôpital Saint Louis, Paris, France (M.R.-R.); Service de Médecine Vasculaire, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris-APHP, Université Paris Descartes, Sorbonne Paris Cité, PARCC, Inserm U970, Centre de Référence National Maladies Vasculaires Rares, Paris, France (T.M., E.M.); Service de Médecine Interne, Hôpital Foch, Université Versailles Saint Quentin en Yvelines, Versailles, France (J.E.K.); Service de Médecine Interne, CHU Lille, Université Lille II, Lille, France (M.L.); Inserm UMR_1109, Fédération de Médecine Translationnelle, Université de Strasbourg, Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France (J.S.); Service de Médecine Interne, CHU Hôtel-Dieu, Nantes, France (A.N., M. Hamidou); Université Paris Descartes, AP-HP, Hôpital Cochin, Centre de Référence Maladies Auto-Immunes et Systémiques Rares, Service de Médecine Interne, Paris, France (P. Cohen, L.G.); Service de Médecine Interne, Hôpital Pitié Salpetrière, Department of Internal Medicine and Clinical Immunology Groupe Hospitalier Pitié-Salpetrière, Université Pierre et Marie Curie, UPMC, Paris, France (M. Hie, Z.A.); Service de Médecine Interne et Immunologie Clinique, Hôpital le Bocage, Dijon, France (S.B.); Service de Médecine Interne, Université Rouen, Rouen, France (I.M.); Service de Médecine Interne et Maladies Vasculaires, Centre de Compétence de Maladies Rares, CHU Angers, Université Angers, Angers, France (C.L.); Service de Médecine Interne, Université Bordeaux, CHU Bordeaux, Bordeaux, France (M.A.V.); Service de Médecine Interne et Immunologie Clinique, Universi
Abstract
BACKGROUND: The goal of this work was to assess the safety and efficacy of biologics (ie, tumor necrosis factor-α antagonists and tocilizumab) in patients with Takayasu arteritis. METHODS AND RESULTS: This was a retrospective, multicenter study of the characteristics and outcomes of 49 patients with Takayasu arteritis (80% female; median age, 42 years [20-55 years] treated by tumor necrosis factor-α antagonists [80%] or tocilizumab [20%]) and fulfilling American College of Rheumatology or Ishikawa criteria. Factors associated with complete response were assessed. Eighty-eight percent of patients with Takayasu arteritis were inadequately controlled with or were intolerant to conventional immunosuppressive therapy (median number, 3 [1-5]). Overall response (ie, complete and partial) to biological-targeted treatments at 6 and 12 months was 75% and 83%, respectively. There were significantly lower C-reactive protein levels at the initiation of biological-targeted treatments (22 mg/L [10-46 mg/L] versus 58 mg/L [26-76 mg/L]; P=0.006) and a trend toward fewer immunosuppressants drugs used before biologics (P=0.054) in responders (ie, complete or partial responders) relative to nonresponders to biological-targeted treatments. C-reactive protein levels and daily prednisone dose significantly decreased after 12 months of biological-targeted treatments (30 versus 6 mg/L [P<0.05] and 15 versus 7.5 mg [P<0.05] at baseline and 12 months, respectively). The 3-year relapse-free survival was 90.9% (83.5%-99%) over the biological treatment period compared with 58.7% (43.3%-79.7%; P=0.0025) with disease-modifying antirheumatic drugs. No difference in efficacy was found between tumor necrosis factor-α antagonists and tocilizumab. After a median follow-up of 24 months (2-95 months), 21% of patients experienced adverse effects, with biological-targeted treatments discontinued in 6.6% of cases. CONCLUSION: This nationwide study shows a high efficacy of biological-targeted treatments in refractory patients with Takayasu arteritis with an acceptable safety profile.
BACKGROUND: The goal of this work was to assess the safety and efficacy of biologics (ie, tumor necrosis factor-α antagonists and tocilizumab) in patients with Takayasu arteritis. METHODS AND RESULTS: This was a retrospective, multicenter study of the characteristics and outcomes of 49 patients with Takayasu arteritis (80% female; median age, 42 years [20-55 years] treated by tumor necrosis factor-α antagonists [80%] or tocilizumab [20%]) and fulfilling American College of Rheumatology or Ishikawa criteria. Factors associated with complete response were assessed. Eighty-eight percent of patients with Takayasu arteritis were inadequately controlled with or were intolerant to conventional immunosuppressive therapy (median number, 3 [1-5]). Overall response (ie, complete and partial) to biological-targeted treatments at 6 and 12 months was 75% and 83%, respectively. There were significantly lower C-reactive protein levels at the initiation of biological-targeted treatments (22 mg/L [10-46 mg/L] versus 58 mg/L [26-76 mg/L]; P=0.006) and a trend toward fewer immunosuppressants drugs used before biologics (P=0.054) in responders (ie, complete or partial responders) relative to nonresponders to biological-targeted treatments. C-reactive protein levels and daily prednisone dose significantly decreased after 12 months of biological-targeted treatments (30 versus 6 mg/L [P<0.05] and 15 versus 7.5 mg [P<0.05] at baseline and 12 months, respectively). The 3-year relapse-free survival was 90.9% (83.5%-99%) over the biological treatment period compared with 58.7% (43.3%-79.7%; P=0.0025) with disease-modifying antirheumatic drugs. No difference in efficacy was found between tumor necrosis factor-α antagonists and tocilizumab. After a median follow-up of 24 months (2-95 months), 21% of patients experienced adverse effects, with biological-targeted treatments discontinued in 6.6% of cases. CONCLUSION: This nationwide study shows a high efficacy of biological-targeted treatments in refractory patients with Takayasu arteritis with an acceptable safety profile.
Authors: Carol A Langford; David Cuthbertson; Steven R Ytterberg; Nader Khalidi; Paul A Monach; Simon Carette; Philip Seo; Larry W Moreland; Michael Weisman; Curry L Koening; Antoine G Sreih; Robert Spiera; Carol A McAlear; Kenneth J Warrington; Christian Pagnoux; Kathleen McKinnon; Lindsy J Forbess; Gary S Hoffman; Renée Borchin; Jeffrey P Krischer; Peter A Merkel Journal: Arthritis Rheumatol Date: 2017-03-08 Impact factor: 10.995
Authors: Diana Castillo-Martínez; Luis M Amezcua-Castillo; Julio Granados; Carlos Pineda; Luis M Amezcua-Guerra Journal: Clin Rheumatol Date: 2020-03-20 Impact factor: 2.980