Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Takayasu arteritis (TA) is often refractory to corticosteroids and traditional immunosuppressive agents. Interleukin (IL)-6 plays an important role in the pathogenesis of TA. Tocilizumab (TCZ) is a humanized monoclonal anti-IL6 receptor (IL-6R) antibody.
Objective: Our aim was to assess the efficacy of TCZ in patients with TA refractory to conventional treatment.
Retrospective multicenter study of 8 patients treated with TCZ and diagnosed with TA refractory to conventional therapy. We assessed its efficacy (clinical and laboratory parameters) and the reduction in the corticosteroid dose, as well as its side effects. Comparisons were performed between baseline and 1st, 3rd, 6th and 12th months, by means of
Eight patients (all women) with a mean age of 34±16 years, median 36 years (range: 7-57) were assessed. The main clinical features at TCZ therapy onset were: constitutional symptoms (n=4), fever (n=3), headache (n=2), chest pain (n=1), abdominal pain (n=1), mesenteric ischemia (n=1), myalgia involving the lower limbs (n=1), cerebral vascular insufficiency (n=1), malaise (n=1), upper limb claudication (n=1) and nodular scleritis (n=1). Besides corticosteroids and before TCZ treatment onset, 7 of 8 patients had also received several conventional immunosuppressive and/or biologic agents. Seven patients experienced marked clinical improvement in the first 3 months after the onset of TCZ therapy. After a median follow-up of 15.5 [interquartile range-IQR: 12-24] months, 7 patients were asymptomatic. The median C-reactive protein decreased from 3.09 [IQR: 0.5-12] to 0.15 [ IQR: 0.1-0.5] mg/dL (p= 0.018), and median erythrocyte sedimentation rate from 40 [IQ range: 28-72] to 3 [IQR: 2-5] mm/1st hour (p= 0.012). The median dose of prednisone was also tapered from 42.5 [IQR: 25-50] to 2.5 [IQR: 0-7.5] mg/day (p= 0.011). However, TCZ had to be discontinued in 1 patient because she developed a systemic lupus erythematosus, and in another patients due to inefficiency. TCZ dose was reduced in a patient because of mild thrombocytopenia.
TCZ appears to be effective in the management of patients with TakA, in particular in patients refractory to corticosteroids and/or conventional immunosuppressive drugs.
To cite this abstract in AMA style:Palmou N, Santos-Gómez M, Loricera J, Blanco R, Hernández JL, Castañeda S, Humbría A, Ortego-Centeno N, Bravo B, Freire M, Melchor S, Minguez M, Salvatierra J, Gonzalez-Vela C, Calvo-Río V, Pina T, Gonzalez-Gay MA. Tocilizumab in Refractory Takayasu Arteritis. a Multicenter Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/tocilizumab-in-refractory-takayasu-arteritis-a-multicenter-study/. Accessed September 21, 2019.
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