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- Title
Efficacy and safety of TNF-α antagonists and tocilizumab in Takayasu arteritis: multicentre retrospective study of 209 patients.
- Authors
Mekinian, Arsène; Biard, Lucie; Dagna, Lorenzo; Novikov, Pavel; Salvarani, Carlo; Espitia, Olivier; Sciascia, Savino; Michaud, Martin; Lambert, Marc; Hernández-Rodríguez, José; Schleinitz, Nicolas; Awisat, Abid; Puéchal, Xavier; Aouba, Achille; Pons, Helene Munoz; Smitienko, Ilya; Gaultier, Jean Baptiste; Mouel, Edwige Le; Benhamou, Ygal; Perlat, Antoinette
- Abstract
Objective To assess the safety and the efficacy of TNF-α antagonists and tocilizumab in patients with Takayasu arteritis (TAK). Methods 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]. Results 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]. Conclusion 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.
- Subjects
DRUG efficacy; RESEARCH; INTRAVENOUS therapy; CONFIDENCE intervals; TOCILIZUMAB; TIME; RETROSPECTIVE studies; INFLIXIMAB; HEALTH outcome assessment; DISEASE incidence; TAKAYASU arteritis; TUMOR necrosis factors; DESCRIPTIVE statistics; ADALIMUMAB; PREDNISONE; ODDS ratio; GOLIMUMAB; CHEMICAL inhibitors
- Publication
Rheumatology, 2022, Vol 61, Issue 4, p1376
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/keab635