Disease progression of Takayasu arteritis in two patients treated with tocilizumab

In recent years there has been growing interest in the use of tocilizumab for the treatment of large vessel vasculitis, particularly giant cell arteritis.1 Nakaoka et al recently suggested that tocilizumab may be of therapeutic benefit in patients with relapsing Takayasu arteritis (TAK).2 In this journal, a case of aortic ulceration in a patient with TAK while on tocilizumab was described.3 We report two additional patients who had disease progression despite tocilizumab therapy. ### Case 1 A 44-year-old woman with a 20-year history of seropositive rheumatoid arthritis in clinical remission on adalimumab presented with new-onset right upper extremity claudication. A diagnosis of TAK was made after angiography demonstrated arterial thickening of the aorta and arch branches with multifocal narrowing of the subclavian and common carotid arteries. …