Efficacy of tocilizumab in Takayasu arteritis: Multicenter retrospective study of 46 patients

Publication date: Available online 17 April 2018
Source:Journal of Autoimmunity
Author(s): Arsene Mekinian, Mathieu Resche-Rigon, Cloé Comarmond, Alessandra Soriano, Joel Constans, Laurent Alric, Patrick Jego, Florian Busato, Matthieu Cabon, Robin Dhote, Lazaro Estibaliz, Isabelle Kone Pault, Cédric Landron, Christian Lavigne, Bertrand Lioger, Martin Michaud, Marc Ruivard, Karim Sacre, Jacques Eric Gottenberg, Francis Gaches, Tiphaine Goulenok, Carlo Salvarani, Patrice Cacoub, Olivier Fain, David Saadoun
ObjectivesTo assess the efficacy of tocilizumab in patients with Takayasu arteritis (TA).MethodsWe conducted a retrospective multicenter study in 46 TA patients treated with tocilizumab. We analyzed factors associated with response to tocilizumab (assessed using NIH score).ResultsForty-six patients with TA were included, with a median age of 43 years [29–54], and 35 (76%) females. We observed a decrease in the median NIH scale (from 3 [2–3] at baseline to 0 [0–1] and 0 at 3 and 6 months, respectively; p < 0.0001). The daily prednisone dose also decreased from 15 mg [8–19] at baseline to 4 mg [5–21] and 5 mg [4.5–9] at 3 and 6 months, respectively (p < 0.0001) under tocilizumab. The overall tocilizumab failure free survival was 81% [CI 95%; 0.7–0.95], 72% [CI 95%; 0.55–0.95] and 48% [CI 95%; 0.2–0.1] at 12, 24 and 48 months, respectively. The presence of constitutional symptoms (HR 5.6 [CI 95%; 1.08–29], p = 0.041), and C-reactive protein level (HR 1.16 [CI 95%; 1.01–1.31], P = 0.003) at the time of tocilizumab initiation were significantly associated with tocilizumab event-free survival. The event-free survival was significantly better under tocilizumab therapy in comparison to DMARDs (p = 0.02).ConclusionThis large multicenter study shows that tocilizumab is efficient and may reduce the incidence of relapses in TA.



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