PMID- 34211589
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220424
IS  - 1759-720X (Print)
IS  - 1759-7218 (Electronic)
IS  - 1759-720X (Linking)
VI  - 13
DP  - 2021
TI  - Tocilizumab in refractory Caucasian Takayasu's arteritis: a multicenter study of 
      54 patients and literature review.
PG  - 1759720X211020917
LID - 10.1177/1759720X211020917 [doi]
LID - 1759720X211020917
AB  - 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 (TCZ(MONO)) and combined 
      with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZ(COMBO)) 
      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 TCZ(MONO) and 31 (57.4%) 
      on TCZ(COMBO): MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). 
      Patients on TCZ(COMBO) 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.
CI  - (c) The Author(s), 2021.
FAU - Prieto-Pena, Diana
AU  - Prieto-Pena D
AD  - Department of Rheumatology, Research Group on Genetic Epidemiology and 
      Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the 
      Musculoskeletal System, IDIVAL, Hospital Universitario Marques de Valdecilla, 
      Santander, Spain.
FAU - Bernabeu, Pilar
AU  - Bernabeu P
AD  - Department of Rheumatology, Hospital General de Alicante, Alicante, Spain.
FAU - Vela, Paloma
AU  - Vela P
AD  - Department of Rheumatology, Hospital General de Alicante, Alicante, Spain.
FAU - Narvaez, Javier
AU  - Narvaez J
AUID- ORCID: 0000-0002-1614-8064
AD  - Department of Rheumatology, Hospital de Bellvitge, Barcelona, Spain.
FAU - Fernandez-Lopez, Jesus C
AU  - Fernandez-Lopez JC
AD  - Department of Rheumatology, Complejo H. Universitario de A Coruna, A Coruna, 
      Spain.
FAU - Freire-Gonzalez, Mercedes
AU  - Freire-Gonzalez M
AD  - Department of Rheumatology, Complejo H. Universitario de A Coruna, A Coruna, 
      Spain.
FAU - Gonzalez-Alvarez, Beatriz
AU  - Gonzalez-Alvarez B
AD  - Department of Rheumatology, Hospital Nuestra Senora de la Candelaria, Tenerife, 
      Spain.
FAU - Solans-Laque, Roser
AU  - Solans-Laque R
AD  - Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain.
FAU - Callejas Rubio, Jose L
AU  - Callejas Rubio JL
AD  - Autoimmune Disease Unit, Hospital San Cecilio, Granada, Spain.
FAU - Ortego, Norberto
AU  - Ortego N
AD  - Autoimmune Disease Unit, Hospital San Cecilio, Granada, Spain.
FAU - Fernandez-Diaz, Carlos
AU  - Fernandez-Diaz C
AD  - Department of Rheumatology, H. Universitario de La Princesa, IIS-Princesa, 
      Madrid, Spain.
FAU - Rubio, Esteban
AU  - Rubio E
AD  - Autoimmune Disease Unit, Hospital Virgen del Rocio, Sevilla, Spain.
FAU - Garcia-Morillo, Salvador
AU  - Garcia-Morillo S
AD  - Autoimmune Disease Unit, Hospital Virgen del Rocio, Sevilla, Spain.
FAU - Minguez, Mauricio
AU  - Minguez M
AD  - Department of Rheumatology, Hospital San Juan de Alicante, Alicante, Spain.
FAU - Fernandez-Carballido, Cristina
AU  - Fernandez-Carballido C
AD  - Department of Rheumatology, Hospital San Juan de Alicante, Alicante, Spain.
FAU - de Miguel, Eugenio
AU  - de Miguel E
AD  - Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain.
FAU - Melchor, Sheila
AU  - Melchor S
AD  - Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain.
FAU - Salgado, Eva
AU  - Salgado E
AD  - Department of Rheumatology, Complejo H. Universitario de Ourense, Ourense, Spain.
FAU - Bravo, Beatriz
AU  - Bravo B
AD  - Department of Rheumatology, Hospital Virgen de las Nieves, Granada, Spain.
FAU - Romero-Yuste, Susana
AU  - Romero-Yuste S
AD  - Department of Rheumatology, Complejo H. Universitario de Pontevedra, Pontevedra, 
      Spain.
FAU - Salvatierra, Juan
AU  - Salvatierra J
AD  - Autoimmune Disease Unit, Hospital San Cecilio, Granada, Spain.
FAU - Hidalgo, Cristina
AU  - Hidalgo C
AD  - Department of Rheumatology, Complejo Universitario de Salamanca, Salamanca, 
      Spain.
FAU - Manrique, Sara
AU  - Manrique S
AD  - Autoimmune Disease Unit, Hospital Regional de Malaga, Malaga, Spain.
FAU - Romero-Gomez, Carlos
AU  - Romero-Gomez C
AD  - Autoimmune Disease Unit, Hospital Regional de Malaga, Malaga, Spain.
FAU - Moya, Patricia
AU  - Moya P
AUID- ORCID: 0000-0001-8339-5420
AD  - Department of Rheumatology, Hospital Sant Pau, Barcelona, Spain.
FAU - Alvarez-Rivas, Noelia
AU  - Alvarez-Rivas N
AD  - Department of Rheumatology, Hospital Universitario San Agustin, Aviles, Spain.
FAU - Mendizabal, Javier
AU  - Mendizabal J
AD  - Department of Rheumatology, Complejo Hospitalario de Navarra, Pamplona, Spain.
FAU - Ortiz-Sanjuan, Francisco
AU  - Ortiz-Sanjuan F
AD  - Department of Rheumatology, Hospital Universitario y Politecnico La Fe, Valencia, 
      Spain.
FAU - Perez de Pedro, Ivan
AU  - Perez de Pedro I
AD  - Autoimmune Disease Unit, Hospital Carlos Haya, Malaga, Spain.
FAU - Alonso-Valdivielso, Jose L
AU  - Alonso-Valdivielso JL
AUID- ORCID: 0000-0002-1862-6883
AD  - Department of Rheumatology, Hospital Universitario de Burgos, Burgos, Spain.
FAU - Perez-Sanchez, Laura
AU  - Perez-Sanchez L
AD  - Department of Rheumatology, Hospital Universitario Reina Sofia, Cordoba, Spain.
FAU - Roldan, Rosa
AU  - Roldan R
AD  - Department of Rheumatology, Hospital Universitario Reina Sofia, Cordoba, Spain.
FAU - Fernandez-Llanio, Nagore
AU  - Fernandez-Llanio N
AD  - Department of Rheumatology, Hospital Arnau de Vilanova, Valencia, Spain.
FAU - Gomez de la Torre, Ricardo
AU  - Gomez de la Torre R
AD  - Autoimmune Disease Unit, Hospital Universitario Central de Asturias, Oviedo, 
      Spain.
FAU - Suarez, Silvia
AU  - Suarez S
AD  - Autoimmune Disease Unit, Hospital Universitario Central de Asturias, Oviedo, 
      Spain.
FAU - Montesa Cabrera, Maria Jesus
AU  - Montesa Cabrera MJ
AD  - Department of Rheumatology, Hospital Nuestra Senora de la Candelaria, Tenerife, 
      Spain.
FAU - Delgado Sanchez, Monica
AU  - Delgado Sanchez M
AD  - Department of Rheumatology, Hospital Nuestra Senora de la Candelaria, Tenerife, 
      Spain.
FAU - Loricera, Javier
AU  - Loricera J
AD  - Department of Rheumatology, Research Group on Genetic Epidemiology and 
      Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the 
      Musculoskeletal System, IDIVAL, Hospital Universitario Marques de Valdecilla, 
      Santander, Spain.
FAU - Atienza-Mateo, Belen
AU  - Atienza-Mateo B
AD  - Department of Rheumatology, Research Group on Genetic Epidemiology and 
      Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the 
      Musculoskeletal System, IDIVAL, Hospital Universitario Marques de Valdecilla, 
      Santander, Spain.
FAU - Castaneda, Santos
AU  - Castaneda S
AD  - Department of Rheumatology, H. Universitario de La Princesa, IIS-Princesa, 
      Madrid, Spain.
FAU - Gonzalez-Gay, Miguel A
AU  - Gonzalez-Gay MA
AUID- ORCID: 0000-0002-7924-7406
AD  - Rheumatology Division, Research Group on Genetic Epidemiology and Atherosclerosis 
      in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal 
      System, IDIVAL, Hospital Universitario Marques de Valdecilla, Avenida Valdecilla 
      s/n, Santander, 39008, Spain.
FAU - Blanco, Ricardo
AU  - Blanco R
AUID- ORCID: 0000-0003-2344-2285
AD  - Department of Rheumatology, Research Group on Genetic Epidemiology and 
      Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the 
      Musculoskeletal System, IDIVAL, Hospital Universitario Marques de Valdecilla, 
      Santander, Spain.
LA  - eng
PT  - Journal Article
DEP - 20210618
PL  - England
TA  - Ther Adv Musculoskelet Dis
JT  - Therapeutic advances in musculoskeletal disease
JID - 101517322
PMC - PMC8216399
OTO - NOTNLM
OT  - Caucasian
OT  - Takayasu's arteritis
OT  - Tocilizumab
OT  - biological therapy
OT  - cDMARDs
COIS- Conflict of interest statement: Disclosures that might be interpreted as 
      constituting of possible conflict(s) of interest for the study: DP-P is supported 
      by a research contract from the Carlos III Health Institute of Spain (Rio Hortega 
      program, ref. CM20/00006) and has received research support from UCB Pharma, 
      Roche, Sanofi, Pfizer, AbbVie, and Lilly. MAG-G received grants/research supports 
      from Abbvie, MSD, Jansen, and Roche and had consultation fees/participation in 
      company sponsored speaker's bureau from Abbvie, Pfizer, Roche, Sanofi, Lilly, 
      Celgene, and MSD. RB received grants/research supports from Abbvie, MSD, and 
      Roche, and had consultation fees/participation in company sponsored speaker's 
      bureau from Abbvie, Lilly, Pfizer, Roche, Bristol-Myers, Janssen, UCB Pharma, and 
      MSD. The remaining authors declare they do not have conflict of interest.
EDAT- 2021/07/03 06:00
MHDA- 2021/07/03 06:01
PMCR- 2021/06/18
CRDT- 2021/07/02 06:38
PHST- 2021/02/07 00:00 [received]
PHST- 2021/05/10 00:00 [accepted]
PHST- 2021/07/02 06:38 [entrez]
PHST- 2021/07/03 06:00 [pubmed]
PHST- 2021/07/03 06:01 [medline]
PHST- 2021/06/18 00:00 [pmc-release]
AID - 10.1177_1759720X211020917 [pii]
AID - 10.1177/1759720X211020917 [doi]
PST - epublish
SO  - Ther Adv Musculoskelet Dis. 2021 Jun 18;13:1759720X211020917. doi: 
      10.1177/1759720X211020917. eCollection 2021.