Abstract
To evaluate the efficacy and safety of tocilizumab (TCZ) in the treatment of refractory Takayasu arteritis (TAK). Eleven refractory TAK patients treated with TCZ at the First Affiliated Hospital of Anhui Medical University between 2017 July and 2020 December were respectively analyzed. We also respectively analyzed the studies on TCZ efficacy in patients with TAK, from PubMed/MEDLINE, Elsevier Science Direct between January 2010 and April 2021. The median age of 11 patients was 34(19–46) years. After 3 months of TCZ, a significant drop was found in median NIH (3[2–5] at baseline vs 1[0–2] after 6 months; p < 0.05), ITAS-2010 score (8.5[6–11] vs 6[1–10]; p < 0.05). One (9%) patient experienced relapse during TCZ treatment. After withdrawal of TCZ, one patient (9%) underwent relapse and nine patients (81%) were spared of GC use. In literature review, a total of 211 patients (mean age 35 years) were analyzed, including 80 (38%) Chinese and 169 females (80%). Among the 211 patients, (154 patients) 73% achieved remission after the last infusion of TCZ; TAK relapsed in 6% of patients during TCZ treatment and 5% of the TCZ patients after the withdrawal of TCZ. A total of 95 types of adverse events were observed in the literature. Infection was the most common adverse effect, occurring in 50% of patients. TCZ could serve as an efficacious and safe agent for refractory TAK.
Highlights
Takayasu arteritis (TAK) is a major large vessel vasculitis involving the aorta, its major branches and the pulmonary arteries [1]
Multiple studies have revealed the active roles of pro-inflammatory cytokines, including tumor necrosis factor α (TNFα) and interleukin-6 (IL-6)
We report a retrospective study and a literature review on the efficacy and tolerance of TCZ in Chinese patients
Summary
Takayasu arteritis (TAK) is a major large vessel vasculitis involving the aorta, its major branches and the pulmonary arteries [1]. TAK is more prevalent in Asia and the Middle East than in other regions [2]. TAK predominantly affects the young women in their twenties or thirties [3]. Without early effective anti-inflammatory treatments, TAK patients may undergo relapse after continuous inflammation and vascular injury [4]. Multiple studies have revealed the active roles of pro-inflammatory cytokines, including tumor necrosis factor α (TNFα) and interleukin-6 (IL-6). IL-6 level increases in the serum, so does its expression in the aorta [5, 6]. IL-6 can mark the activity of various diseases [7].
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