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http://hdl.handle.net/2445/179984
Title: | Tocilizumab in refractory Caucasian Takayasu’s arteritis: a multicenter study of 54 patients and literature review |
Author: | Prieto Peña, Diana Bernabeu, Pilar Vela, Paloma Narváez, Javier Fernández López, Jesús C. Freire González, Mercedes González Álvarez, Beatriz Solans Laqué, Roser Callejas Rubio, José Luis Ortego Centeno, Norberto Fernández Díaz, Carlos Rubio, Esteban García Morillo, Salvador Minguez, Mauricio Fernández Carballido, Cristina Miguel, Eugenio de Melchor, Sheila Salgado, Eva Bravo, Beatriz Romero Yuste, Susana Salvatierra, Juan Hidalgo, Cristina Manrique Arija, Sara Romero Gómez, Carlos Moya, Patricia Álvarez Rivas, Noelia Mendizabal, Javier Ortiz Sanjuán, Francisco Pérez de Pedro, Iván Alonso Valdivielso, José L. Pérez Sánchez, Laura Roldán, Rosa Fernandez-Llanio, Nagore Gómez de la Torre, Ricardo Suarez, Silvia Montesa Cabrera, María Jesús Delgado Sánchez, Mónica Loricera, Javier Atienza Mateo, Belén Castañeda, Santos González Gay, Miguel A. Blanco, Ricardo |
Keywords: | Arteritis Blancs Arteritis Whites |
Issue Date: | 1-Jan-2021 |
Publisher: | SAGE Publications |
Abstract: | Objective: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu's arteritis (TAK) in clinical practice. Methods: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZMONO) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZCOMBO) was performed. Results: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5-50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0-31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5-50.0) to 5.0 (0.0-5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0-14.0) months. Twenty-three (42.6%) patients were on TCZMONO and 31 (57.4%) on TCZCOMBO: MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). Patients on TCZCOMBO were younger [38.0 (27.0-46.0) versus 45.0 (38.0-57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0-38.0) versus 6.0 (1.0-23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7-5.6) versus 1.3 (0.3-3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. Conclusion: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin. |
Note: | Reproducció del document publicat a: https://doi.org/10.1177/1759720X211020917 |
It is part of: | Therapeutic Advances in Musculoskeletal Disease, 2021, vol. 13, p. 1759720-2110209 |
URI: | http://hdl.handle.net/2445/179984 |
Related resource: | https://doi.org/10.1177/1759720X211020917 |
ISSN: | 1759-7218 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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