Giulia Pazzola1,2, Francesco Muratore1,2, Nicolò Pipitone1, Filippo Crescentini1, Patrice Cacoub3,4,5,6, Luigi Boiardi1, Lucia Spaggiari7, Cloe Comarmond3,4,5,6, Stefania Croci8, David Saadoun3,4,5,6, Carlo Salvarani1,2. 1. Rheumatology Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy. 2. Università di Modena e Reggio Emilia, Italy. 3. Inflammation-Immunopathology-Biotherapy Department (DHU i2B), UMR 7211, UPMC Université Paris 06, Sorbonne Universités, Paris, F-75005. 4. INSERM, UMR_S 959, Paris, France. 5. CNRS, FRE3632, Paris, France. 6. Department of Internal Medicine and Clinical Immunology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre de référence des maladies Autoimmunes et Systémiques rares, Paris, France. 7. Department of Radiology, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy. 8. Inflammation Laboratory, Clinical Immunology, Allergology and Advanced Biotechnologies Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy.
Abstract
OBJECTIVES: To assess the efficacy and safety of rituximab (RTX) in patients with Takayasu arteritis (TAK). METHODS: We conducted a retrospective study on seven TAK patients treated with RTX. Six of the seven patients had a disease refractory to high dose glucocorticoids and conventional immunosuppressive and/or biologic agents. One newly diagnosed, treatment-naïve TAK patient refused glucocorticoids and received RTX alone. Clinical evaluation, laboratory tests and imaging modalities (CT or MR-angiography, and 18F-fluorodeoxyglucose PET/CT) were performed at first RTX administration and every 6 months thereafter. Disease activity was assessed using the Kerr index. We also performed a literature review using PubMed, Ovid MEDLINE and Cochrane library. RESULTS: Seven patients (6 females) were included in the study. Mean (s.d.) age was 32.4 (17.3) years. At first RTX administration, all patients had active disease according to the Kerr index (⩾2), and had also evidence of active disease at PET/CT. Despite RTX treatment, four of the seven patients had evidence of persistent disease activity and/or radiographic disease progression during follow-up. Three out of seven patients in whom RTX was employed as rescue therapy achieved complete remission. In the literature review, we identified five papers describing nine patients treated with RTX with good results in eight cases, but short follow-up. CONCLUSION: Our data do not support a role for RTX as first line biologic therapy in TAK patients, but it may have a role in some patients as second or third line biologic therapy.
OBJECTIVES: To assess the efficacy and safety of rituximab (RTX) in patients with Takayasu arteritis (TAK). METHODS: We conducted a retrospective study on seven TAK patients treated with RTX. Six of the seven patients had a disease refractory to high dose glucocorticoids and conventional immunosuppressive and/or biologic agents. One newly diagnosed, treatment-naïve TAK patient refused glucocorticoids and received RTX alone. Clinical evaluation, laboratory tests and imaging modalities (CT or MR-angiography, and 18F-fluorodeoxyglucose PET/CT) were performed at first RTX administration and every 6 months thereafter. Disease activity was assessed using the Kerr index. We also performed a literature review using PubMed, Ovid MEDLINE and Cochrane library. RESULTS: Seven patients (6 females) were included in the study. Mean (s.d.) age was 32.4 (17.3) years. At first RTX administration, all patients had active disease according to the Kerr index (⩾2), and had also evidence of active disease at PET/CT. Despite RTX treatment, four of the seven patients had evidence of persistent disease activity and/or radiographic disease progression during follow-up. Three out of seven patients in whom RTX was employed as rescue therapy achieved complete remission. In the literature review, we identified five papers describing nine patients treated with RTX with good results in eight cases, but short follow-up. CONCLUSION: Our data do not support a role for RTX as first line biologic therapy in TAK patients, but it may have a role in some patients as second or third line biologic therapy.
Authors: Dan Pugh; Maira Karabayas; Neil Basu; Maria C Cid; Ruchika Goel; Carl S Goodyear; Peter C Grayson; Stephen P McAdoo; Justin C Mason; Catherine Owen; Cornelia M Weyand; Taryn Youngstein; Neeraj Dhaun Journal: Nat Rev Dis Primers Date: 2022-01-06 Impact factor: 65.038
Authors: Francesca Regola; Martina Uzzo; Paola Toniati; Barbara Trezzi; Renato Alberto Sinico; Franco Franceschini Journal: Front Med (Lausanne) Date: 2022-01-12
Authors: Ana F Águeda; Sara Monti; Raashid Ahmed Luqmani; Frank Buttgereit; Maria Cid; Bhaskar Dasgupta; Christian Dejaco; Alfred Mahr; Cristina Ponte; Carlo Salvarani; Wolfgang Schmidt; Bernhard Hellmich Journal: RMD Open Date: 2019-09-23