Biologics for Takayasu Arteritis

Biologics for Takayasu Arteritis

A multicentric retrospective analysis of 49 patients with Takayasu arteritis refractory to steroids or disease modifying drugs (mostly methotrexate and azathioprine) treated with biologics {tumor necrosis factor (TNF) alpha antagonists or tocilizumab} has been reported in Circulation [1].

Tocilizumab is a monoclonal antibody directed against interleukin 6 (IL-6). Overall response to biologics for Takayasu arteritis was 83% at one year (either partial or complete remission). The responders had a lower initial C-reactive protein levels and lower requirement for steroids. Both C-reactive protein levels and steroid requirement decreased significantly at 12 months treatment with biologicals. The 3 year relapse free survival was 90.9% with biologically targeted therapy compared with 58.7% for disease modifying therapy. There was no difference in efficacy between TNF alpha antagonists and tocilizumab. Over a median follow up period of 2 years, about one fifth of them had adverse effects with biologically targeted therapy and 6.6% had discontinued treatment. The authors concluded that biologics for Takayasu Arteritis had high efficacy and an acceptable safety profile.

Reference

1. Arsene Mekinian, Cloé Comarmond, Mathieu Resche-Rigon, Tristan Mirault, Jean Emmanuel Kahn, Marc Lambert, Jean Sibilia, Antoine Néel, Pascal Cohen, Miguel Hie, Sabine Berthier, Isabelle Marie, Christian Lavigne, Marie Anne Vandenhende, Géraldine Muller, Zahir Amoura, Hervé Devilliers, Sébastien Abad, Mohamed Hamidou, Loïc Guillevin, Robin Dhote, Bertrand Godeau, Emmanuel Messas, Patrice Cacoub, Olivier Fain, David Saadoun, French Takayasu Network. Efficacy of Biological-Targeted Treatments in Takayasu Arteritis: Multicenter, Retrospective Study of 49 Patients. Circulation. 2015 Nov 3;132(18):1693-700.