Abstract |
High-dose corticosteroids (CS) are the mainstay of treatment for temporal ( giant cell) arteritis (TA). A usually required long-term treatment with CS, ranging from 1 to 5 years or more, frequently leads to serious side effects in about 60% of patients. There is no conclusive evidence about the role of immunosuppressive agents like methotrexate and azathioprine in the treatment of TA. There are few reports of treatment of refractory or steroid-dependent TA with tumor necrosis factor alpha ( TNF-alpha) inhibitors including infliximab and etanercept. TA is characterized by infiltration of the vessel wall by macrophages, giant cells, and T lymphocytes, with production of several cytokines responsible for the acute phase response. TNF-alpha has been demonstrated in up to 60% of the cells in all areas of inflamed arteries by immunohistochemical techniques; hence, it could play a pivotal role in the pathogenesis of TA. We report the first case of resistant TA, which was treated successfully with adalimumab, a fully human recombinant IgG1, anti- TNF-alpha monoclonal antibody. The efficacy of TNF-alpha inhibitors in resistant TA should be studied in larger, controlled studies.
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Authors | M Mubashir Ahmed, Eisha Mubashir, Samina Hayat, Marjorie Fowler, Seth Mark Berney |
Journal | Clinical rheumatology
(Clin Rheumatol)
Vol. 26
Issue 8
Pg. 1353-5
(Aug 2007)
ISSN: 0770-3198 [Print] Germany |
PMID | 16944071
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Adrenal Cortex Hormones
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Humanized
- Immunologic Factors
- Adalimumab
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Topics |
- Adalimumab
- Adrenal Cortex Hormones
(adverse effects, pharmacology)
- Aged
- Antibodies, Monoclonal
(therapeutic use)
- Antibodies, Monoclonal, Humanized
- Drug Resistance
- Female
- Giant Cell Arteritis
(drug therapy)
- Humans
- Immunologic Factors
(therapeutic use)
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