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Monday, February 12th, 2018
Table of Contents

1 Introduction
5 PMID
 [F] Diseases Research  / PubMed Research Articles  /
Tocilizumab and refractory Takayasu disease: Four case reports and systematic review.

PubMed

 

Resource

Autoimmunity reviews Feb ; ()

Authors

Decker P1; Olivier P2; Risse J3; Zuily S4; Wahl D5;

Author Information
  • 1Vascular Medicine Division and Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Hôpitaux de Brabois, CHRU de Nancy, 5 rue du Morvan, 54500 Vandoeuvre-lès-Nancy, France; Department of Nuclear Medicine, Hôpitaux de Brabois, CHRU de Nancy, 5 rue du Morvan, 54500 Vandoeuvre-lès-Nancy, France.
  • 2University of Lorraine, Nancy, France; INSERM UMR_S 1116, Vandoeuvre-lès-Nancy, France.
  • 3Vascular Medicine Division and Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Hôpitaux de Brabois, CHRU de Nancy, 5 rue du Morvan, 54500 Vandoeuvre-lès-Nancy, France.
  • 4Vascular Medicine Division and Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Hôpitaux de Brabois, CHRU de Nancy, 5 rue du Morvan, 54500 Vandoeuvre-lès-Nancy, France; University of Lorraine, Nancy, France; INSERM UMR_S 1116, Vandoeuvre-lès-Nancy, France.
  • 5Vascular Medicine Division and Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Hôpitaux de Brabois, CHRU de Nancy, 5 rue du Morvan, 54500 Vandoeuvre-lès-Nancy, France; University of Lorraine, Nancy, France; INSERM UMR_S 1116, Vandoeuvre-lès-Nancy, France. Electronic address: d.wahl@chru-nancy.fr.

Abstract

BACKGROUND: Relapses upon corticosteroids tapering and immunosuppressive agents are frequent in Takayasu arteritis (TA). Interleukin-6 is highly involved in physiopathology of TA. Many reports showed efficacy of tocilizumab (TCZ) in refractory TA cases. We report four cases and an updated literature review on the TCZ efficacy and safety in patients with TA.

METHODS: Patients with TA defined by ACR 1990 criteria were included. Clinical, biological and imaging data were retrospectively reported. Disease activity was analyzed before TCZ and during the follow-up. Medline database was searched for systematic literature review.

RESULTS: One hundred and five patients (median age 28 years [22-38]) were included, mostly refractory cases (76 patients, 72%). Median TCZ duration was 12 months [6-20]. Among 105 patients, 90 patients (85.7%) had an initial clinical response within three months [3-6] and 43/66 patients (65.2%) had a radiological improvement. Only seven patients (9%) showed relapse on therapy. Corticosteroid dose reduction was obtained in 75/83 patients (90.4%). Relapse after TCZ discontinuation was observed in six patients (46%), with a median time of five months [2-9]. Twenty-four side-effects were noted in 18 patients (18%), with TCZ interruption in seven cases (7%): 10 infections, five cytopenia, six hepatitis, one pancreatitis, one cutaneous rash and one breast cancer.

CONCLUSIONS: This review confirms that TCZ is safe and effective in refractory cases of TA and TCZ is a corticosteroid-sparing therapy in patients with or without previous TNFα blockers therapy. However relapses after TCZ discontinuation are frequent.

Copyright © 2018. Published by Elsevier B.V.

PMID

29427826

Others

Publication Type: Journal Article, Review


This article is licensed under the the National Library of Medicine License. It uses material from the PubMed National Library of Medicine Data.


Last Modified:   2016-03-27


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