Treatment of refractory Takayasu arteritis with tocilizumab: 7 Italian patients from a single referral center.

Abstract

OBJECTIVE:

The aim of our study was to evaluate the safety and the efficacy of tocilizumab (TCZ) for refractory Takayasu arteritis (TA).

METHODS:

We retrospectively assessed the outcome of blocking interleukin (IL)-6 with TCZ in 7 consecutive patients with refractory TA using a combination of clinical and imaging assessment.

RESULTS:

During a median followup visit at 14 months, 4 patients taking TCZ [including 2 nonresponders to tumor necrosis factor (TNF) inhibitors] achieved clinical response, suggesting a nonredundant role for IL-6 in TA. Inflammatory markers normalized in all patients treated with TCZ. However, vascular progression occurred in 4 patients, suggesting the involvement of other inflammatory pathways and confirming the limitations of erythrocyte sedimentation rate and C-reactive protein for disease activity assessment while taking TCZ. Three patients experienced adverse events and 2 suspended TCZ.

CONCLUSION:

TCZ may be effective in a subset of patients with refractory TA, even in cases of unresponsiveness to TNF inhibitors. Inflammatory markers are not valid markers of TA activity on TCZ. Further studies are needed to confirm these preliminary observations.

• Authors: Enrico Tombetti, Stefano Franchini, Maurizio Papa, Maria Grazia Sabbadini, Elena Baldissera
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 40 Issue 12 Pg. 2047-51 (Dec 2013) ISSN: 0315-162X [Print] Canada
• PMID: 24187104 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents
• IL6 protein, human
• Interleukin-6
• tocilizumab

Topics

• Adult
• Antibodies, Monoclonal, Humanized (administration & dosage, adverse effects)
• Antirheumatic Agents (administration & dosage, adverse effects)
• Drug Resistance
• Female
• Follow-Up Studies
• Humans
• Interleukin-6 (antagonists & inhibitors)
• Italy
• Magnetic Resonance Imaging
• Referral and Consultation
• Retrospective Studies
• Takayasu Arteritis (drug therapy, pathology)
• Treatment Outcome
• Young Adult