Efficacy and safety of TNF-α antagonists and tocilizumab in Takayasu arteritis: multicentre retrospective study of 209 patients
| Autor: | Jean Baptiste Gaultier, Savino Sciscia, Elena Galli, Alessandro Tomelleri, Francis Gaches, Lucie Biard, Bertrand Lioger, Alberto Logullo, Elena Baldissera, Mathieu Vautier, Tiphaine Goulenok, Abid Awisat, Sergey Moiseev, Moya Alvarado, Ilya Smitienko, Le Mouel Edwige, Pascal Woaye-Hune, Corrado Campochiaro, Pavel Novikov, Ygal Benhamou, Carlo Salvarani, Arsène Mekinian, Marc Lambert, Hassold Nolan, Masataka Kuwana, Olivier Espita, François Maurier, Lorenzo Dagna, Isabelle Kone Pault, Patricia Boiardi Luigi, Antoinette Perlat, Helene Munoz Pons, Thomas Sené, Sébastien Humbert, Muratore Francesco, Sabine Berthier, Alexandre Belot, Xavier Puéchal, Achille Aouba, Martin Michaud, Alexandra Audemard-Verger, Jonathan Broner, Julie Seguier, David Saadoun, Karim Sacre, Patrice Cacoub, José Hernández-Rodríguez, Virginie Dufrost, Faten Frikha, Patrick Jego, Nicolas Schleinitz, Guillaume Denis, Olivier Fain, Pierre Zeminsky |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Adult
medicine.medical_specialty vasculitis treatment Antibodies Monoclonal Humanized Gastroenterology Antibodies Etanercept chemistry.chemical_compound Tocilizumab Rheumatology Prednisone Recurrence Internal medicine biotherapies Monoclonal medicine Adalimumab Humans Pharmacology (medical) Cumulative incidence Humanized Retrospective Studies business.industry Tumor Necrosis Factor-alpha Takayasu Arteritis Infliximab Golimumab Discontinuation Treatment Outcome Takayasu arteritis chemistry Female Tumor Necrosis Factor Inhibitors business medicine.drug |
| Popis: | 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|