医学
托珠单抗
大动脉炎
内科学
回顾性队列研究
动脉炎
血管炎
类风湿性关节炎
疾病
作者
A. Mékinian,Lucie Biard,Lorenzo Dagna,Pavel Novikov,Carlo Salvarani,Olivier Espitia,Savino Sciascia,Martin Michaud,M. Lambert,José Hernández‐Rodríguez,N. Schleinitz,Abid Awisat,Xavier Puéchal,Achille Aouba,Helene Munoz Pons,Ilya Smitienko,Jean Baptiste Gaultier,Edwige Le Mouel,Y. Benhamou,Antoinette Perlat
出处
期刊:Rheumatology
[Oxford University Press]
日期:2021-08-05
卷期号:61 (4): 1376-1384
被引量:34
标识
DOI:10.1093/rheumatology/keab635
摘要
To assess the safety and the efficacy of TNF-α antagonists and tocilizumab in patients with Takayasu arteritis (TAK). A total of 209 patients with TAK [median age 29 years (interquartile range 7-62)], 186 (89%) females] were included. They received either TNF-α antagonists [n = 132 (63%) with 172 lines; infliximab (n = 109), adalimumab (n = 45), golimumab (n = 8), certolizumab (n = 6) and etanercept (n = 5)] or tocilizumab [n = 77 (37%) with 121 lines; i.v. and s.c. in 95 and 26 cases, respectively]. A complete response at 6 months was evidenced in 101/152 (66%) patients on TNF-α antagonists and 75/107 (70%) patients on tocilizumab. Age ≥30 years [odds ratio 2.09 (95% CI 1.09, 3.99)] was associated with complete response, whereas vascular signs [OR 0.26 (95% CI 0.1, 0.65)], baseline prednisone ≥20 mg/day [OR 0.51 (95% CI 0.28, 0.93)] were negatively associated with the complete response to TNF-α antagonists or tocilizumab. During a median follow-up of 36 months, 103 relapses were noted. Supra-aortic branches and thoracic aorta involvement [HR 2.44 (95% CI 1.06, 5.65) and 3.66 (1.18, 11.4), respectively] and systemic signs at baseline [HR 2.01 (95% CI 1.30, 3.11)] were significantly associated with relapse. The cumulative incidence of treatment discontinuation and relapse were similar in TNF-α antagonists and tocilizumab. Fifty-eight (20%) adverse effects occurred on biologic targeted therapies [37 (21%) on TNF-α antagonists and 21 (17%) on tocilizumab (P = 0.4), respectively]. This large multicentre study shows high efficacy of biologic targeted treatments in refractory TAK. Efficacy, relapse and drug retention rate were equivalent with TNF-α antagonists and tocilizumab.
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