Efficacy and safety of TNF-α antagonists and tocilizumab in Takayasu arteritis: multicentre retrospective study of 209 patients.

Abstract

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.

• Authors: Arsène Mekinian, Lucie Biard, Lorenzo Dagna, Pavel Novikov, Carlo Salvarani, Olivier Espitia, Savino Sciascia, Martin Michaud, Marc Lambert, José Hernández-Rodríguez, Nicolas Schleinitz, Abid Awisat, Xavier Puéchal, Achille Aouba, Helene Munoz Pons, Ilya Smitienko, Jean Baptiste Gaultier, Edwige Le Mouel, Ygal Benhamou, Antoinette Perlat, Patrick Jego, Tiphaine Goulenok, Karim Sacre, Bertrand Lioger, Nolan Hassold, Jonathan Broner, Virginie Dufrost, Thomas Sene, Julie Seguier, Francois Maurier, Sabine Berthier, Alexandre Belot, Faten Frikha, Guillaume Denis, Alexandra Audemard-Verger, Isabelle Kone Pault, Sebastien Humbert, Pascal Woaye-Hune, Alessandro Tomelleri, Elena Baldissera, Masataka Kuwana, Alberto Lo Gullo, Francis Gaches, Pierre Zeminsky, Elena Galli, Moya Alvarado, Luigi Boiardi, Francesco Muratore, Mathieu Vautier, Corrado Campochiaro, Sergey Moiseev, Patrice Cacoub, Olivier Fain, David Saadoun, French Takayasu network
• Journal: Rheumatology (Oxford, England) (Rheumatology (Oxford)) Vol. 61 Issue 4 Pg. 1376-1384 (04 11 2022) ISSN: 1462-0332 [Electronic] England
• PMID: 34363461 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].

Chemical References

• Antibodies, Monoclonal, Humanized
• Tumor Necrosis Factor Inhibitors
• Tumor Necrosis Factor-alpha
• tocilizumab

Topics

• Adult
• Antibodies, Monoclonal, Humanized
• Female
• Humans
• Recurrence
• Retrospective Studies
• Takayasu Arteritis (complications, drug therapy)
• Treatment Outcome
• Tumor Necrosis Factor Inhibitors
• Tumor Necrosis Factor-alpha