Article Dans Une Revue Rheumatology Année : 2022

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

1 CHU Saint-Antoine [AP-HP]
2 SU - Sorbonne Université
3 I3 - Immunologie - Immunopathologie - Immunothérapie [CHU Pitié Salpêtrière]
4 Service de biostatistiques et information médicale [Saint-Louis]
5 ECSTRRA [CRESS - U1153 / UMR_A 1125] - Epidemiology and Clinical Statistics for Tumor, Respiratory, and Resuscitation | Epidémiologie Clinique, STatistique, pour la Recherche en Santé
6 IRCCS San Raffaele Scientific Institute [Milan, Italie]
7 Sechenov First Moscow State Medical University
8 UNIMORE - Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia
9 Hôpital Hôtel-Dieu [CHU Nantes]
10 UNITO - Università degli studi di Torino = University of Turin
11 OSGB - Ospedale San Giovanni Bosco [Turin, Italy]
12 HJD - Hôpital Joseph Ducuing - Varsovie [Toulouse]
13 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
14 Université de Lille
15 IDIBAPS - Institut d'Investigacions Biomèdiques August Pi i Sunyer
16 Clinic Barcelona Hospital Universitari
17 UB - Universitat de Barcelona
18 TIMONE - Hôpital de la Timone [CHU - APHM]
19 Bnai Zion Hospital
20 UPD5 - Université Paris Descartes - Paris 5
21 CRMR - Centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte d'Île de France, Est et Ouest / Reference center for rare systemic autoimmune and autoinflammatory diseases in adults in Île-de-France, East and West
22 Service de médecine interne [CHU Caen]
23 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
24 Medical Center K-31 [Moscou]
25 Centre Hospitalier Universitaire [Rennes]
26 CHU Rouen
27 UNIROUEN - Université de Rouen Normandie
28 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
29 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
30 CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation
31 CHB - Centre Hospitalier Simone-Veil de Blois [Blois]
32 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
33 Université Paris-Saclay
34 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
35 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
36 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
37 CHU Rothschild [AP-HP]
38 CH Metz - Robert Schuman, Metz Vantoux
39 UB - Université de Bourgogne
40 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
41 HCL - Hospices Civils de Lyon
42 CIRI-LYACTS - Activation et transduction du signal dans les lymphocytes - Lymphocyte activation and signaling [CIRI]
43 CHU Sfax - Hedi Chaker Hospital [Sfax]
44 FMS - Faculté de médecine - Faculty of Medicine [Sfax, Tunisie]
45 CH Rochefort - Centre Hospitalier de Rochefort
46 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
47 UT - Université de Tours
48 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
49 CHR La réunion
50 Ospedale San Raffaele
51 Nippon Medical School [Tokyo, Japon]
52 IRCCS Messina - Centro Neurolesi Bonino Pulejo Messina
53 Azienda USL—IRCCS di Reggio Emilia [Reggio Emilia]
54 AP-HP - Hopital Saint-Louis [AP-HP]
55 UniSR - Universita Vita Salute San Raffaele = Vita-Salute San Raffaele University [Milan, Italie]
56 CHU Pitié-Salpêtrière [AP-HP]
Olivier Espitia
Abid Awisat
  • Fonction : Auteur
Thomas Sene
Alessandro Tomelleri
Masataka Kuwana

Résumé

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.

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Dates et versions

hal-04889435 , version 1 (15-01-2025)

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Citer

Arsène Mekinian, Lucie Biard, Lorenzo Dagna, Pavel Novikov, Carlo Salvarani, et al.. Efficacy and safety of TNF-α antagonists and tocilizumab in Takayasu arteritis: multicentre retrospective study of 209 patients. Rheumatology, 2022, 61 (4), pp.1376-1384. ⟨10.1093/rheumatology/keab635⟩. ⟨hal-04889435⟩
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