Journal Articles Rheumatology Year : 2022

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

Arsène Mekinian
Lucie Biard
  • Function : Author
Lorenzo Dagna
  • Function : Author
Pavel Novikov
  • Function : Author
Carlo Salvarani
  • Function : Author
Olivier Espitia
  • Function : Author
Savino Sciascia
Martin Michaud
  • Function : Author
Marc Lambert
  • Function : Author
Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167
José Hernández-Rodríguez
Nicolas Schleinitz
  • Function : Author
Abid Awisat
  • Function : Author
Xavier Puéchal
Achille Aouba
  • Function : Author
Helene Munoz Pons
  • Function : Author
Ilya Smitienko
  • Function : Author
Jean Baptiste Gaultier
  • Function : Author
Edwige Le Mouel
  • Function : Author
Ygal Benhamou
  • Function : Author
Antoinette Perlat
  • Function : Author
Patrick Jego
  • Function : Author
Tiphaine Goulenok
Karim Sacre
Bertrand Lioger
  • Function : Author
Nolan Hassold
  • Function : Author
Jonathan Broner
Virginie Dufrost
  • Function : Author
Thomas Sene
Julie Seguier
  • Function : Author
Francois Maurier
  • Function : Author
Sabine Berthier
  • Function : Author
Alexandre Belot
Faten Frikha
  • Function : Author
Guillaume Denis
  • Function : Author
Alexandra Audemard-Verger
Isabelle Kone Pault
Sebastien Humbert
  • Function : Author
Pascal Woaye-Hune
  • Function : Author
Alessandro Tomelleri
Elena Baldissera
  • Function : Author
Masataka Kuwana
Alberto Lo Gullo
  • Function : Author
Francis Gaches
  • Function : Author
Pierre Zeminsky
  • Function : Author
Elena Galli
  • Function : Author
Moya Alvarado
  • Function : Author
Luigi Boiardi
  • Function : Author
Francesco Muratore
  • Function : Author
Mathieu Vautier
  • Function : Author
Corrado Campochiaro
Sergey Moiseev
  • Function : Author
Patrice Cacoub
  • Function : Author
Olivier Fain
David Saadoun
  • Function : Author

Abstract

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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https://hal.science/hal-04399095

Submitted on : Wednesday, January 17, 2024-8:30:18 AM

Last modification on : Thursday, December 19, 2024-11:12:04 AM

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hal-04399095 , version 1 (17-01-2024)

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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-04399095⟩

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