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Tocilizumab treatment effectively improves coronary artery involvement in patients with Takayasu arteritis.
- Source :
-
Clinical rheumatology [Clin Rheumatol] 2020 Aug; Vol. 39 (8), pp. 2369-2378. Date of Electronic Publication: 2020 Mar 06. - Publication Year :
- 2020
-
Abstract
- Objective: Coronary artery involvement in Takayasu arteritis (TAK) leads to poor prognosis and high mortality. Tocilizumab (TCZ) has been used to effectively treat large vessel vasculitis. However, the efficacy of TCZ in resolving coronary artery involvement in TAK is unclear. The aim of this retrospective study was to evaluate the efficacy of TCZ in the treatment of coronary artery involvement in TAK.<br />Methods: Clinical features and manifestations of coronary artery lesions in 11 TAK patients were evaluated before and after TCZ treatment, and the results were compared with those of 11 patients treated with traditional disease-modifying antirheumatic drugs (DMARDs).<br />Results: C-reactive protein (p = 0.006), erythrocyte sedimentation rate (ESR) (p = 0.011), and Kerr score (p = 0.007) were significantly decreased post-TCZ treatment for 6 months. The Indian Takayasu Clinical Activity Score (ITAS) 2010 (p = 0.019) and ITAS-A (p = 0.019) were significantly lower in patients treated with TCZ compared with those treated with traditional DMARDs. The glucocorticoid (GC) dose was tapered to 2.50 (0.00, 7.50) mg day <superscript>-1</superscript> after TCZ treatment for 6 months, which was significantly lower than the GC dose after traditional DMARDs treatment [10.0 (5.00, 11.25) mg.day <superscript>-1</superscript> , (p = 0.033)]. After 6-month TCZ treatment, the total number of coronary artery lesions was reduced from 23 to 15 in 6 patients. Vascular wall thickening was remarkably improved in 2 lesions (in the ostia of the left main and right coronary arteries).<br />Conclusion: TCZ may decrease the disease activity and improve coronary artery lesion in patients with TAK. Key Points • TCZ treatment significantly decreased the disease activity in TAK patients with coronary artery involvement. • TCZ treatment significantly reduces the dosage of GC. • TCZ treatment led to an improvement in imaging findings of TAK patients with coronary artery involvement.
- Subjects :
- Adult
Antibodies, Monoclonal, Humanized administration & dosage
Antirheumatic Agents therapeutic use
Blood Sedimentation
C-Reactive Protein metabolism
Female
Glucocorticoids therapeutic use
Humans
Male
Middle Aged
Retrospective Studies
Takayasu Arteritis pathology
Treatment Outcome
Antibodies, Monoclonal, Humanized therapeutic use
Coronary Vessels drug effects
Coronary Vessels pathology
Takayasu Arteritis drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1434-9949
- Volume :
- 39
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Clinical rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 32144625
- Full Text :
- https://doi.org/10.1007/s10067-020-05005-7