Efficacy of Biological-Targeted Treatments in Takayasu Arteritis Multicenter, Retrospective Study of 49 Patients
Affiliation auteurs | !!!! Error affiliation !!!! |
Titre | Efficacy of Biological-Targeted Treatments in Takayasu Arteritis Multicenter, Retrospective Study of 49 Patients |
Type de publication | Journal Article |
Year of Publication | 2015 |
Auteurs | Mekinian A, Comarmond C, Resche-Rigon M, Mirault T, Kahn JEmmanuel, Lambert M, Sibilia J, Neel A, Cohen P, Hie M, Berthier S, Marie I, Lavigne C, Vandenhende MAnne, Muller G, Amoura Z, Devilliers H, Abad S, Hamidou M, Guillevin L, Dhote R, Godeau B, Messas E, Cacoub P, Fain O, Saadoun D, Network FTakayasu |
Journal | CIRCULATION |
Volume | 132 |
Pagination | 1693-1700 |
Date Published | NOV 3 |
Type of Article | Article |
ISSN | 0009-7322 |
Mots-clés | biological therapy, Takayasu arteritis, Treatment outcome, vasculitis |
Résumé | Background-The goal of this work was to assess the safety and efficacy of biologics (ie, tumor necrosis factor-a antagonists and tocilizumab) in patients with Takayasu arteritis. Methods and Results-This was a retrospective, multicenter study of the characteristics and outcomes of 49 patients with Takayasu arteritis (80% female; median age, 42 years [20-55 years] treated by tumor necrosis factor-a antagonists [80%] or tocilizumab [20%]) and fulfilling American College of Rheumatology or Ishikawa criteria. Factors associated with complete response were assessed. Eighty-eight percent of patients with Takayasu arteritis were inadequately controlled with or were intolerant to conventional immunosuppressive therapy (median number, 3 [1-5]). Overall response (ie, complete and partial) to biological-targeted treatments at 6 and 12 months was 75% and 83%, respectively. There were significantly lower C-reactive protein levels at the initiation of biological-targeted treatments (22 mg/L [10-46 mg/L] versus 58 mg/L [26-76 mg/L]; P=0.006) and a trend toward fewer immunosuppressants drugs used before biologics (P=0.054) in responders (ie, complete or partial responders) relative to nonresponders to biological-targeted treatments. C-reactive protein levels and daily prednisone dose significantly decreased after 12 months of biological-targeted treatments (30 versus 6 mg/L [P<0.05] and 15 versus 7.5 mg [P<0.05] at baseline and 12 months, respectively). The 3-year relapse-free survival was 90.9% (83.5%-99%) over the biological treatment period compared with 58.7% (43.3%-79.7%; P=0.0025) with disease-modifying antirheumatic drugs. No difference in efficacy was found between tumor necrosis factor-a antagonists and tocilizumab. After a median follow-up of 24 months (2-95 months), 21% of patients experienced adverse effects, with biological-targeted treatments discontinued in 6.6% of cases. Conclusion-This nationwide study shows a high efficacy of biological-targeted treatments in refractory patients with Takayasu arteritis with an acceptable safety profile. |
DOI | 10.1161/CIRCULATIONAHA.114.014321 |