Refractory Takayasu arteritis successfully treated with rituximab: case-based review

Area of Science:

• Immunology
• Rheumatology
• Vascular Medicine

Background:

• Takayasu arteritis (TAK) is a large-vessel vasculitis impacting the aorta and its branches.
• While T-cell autoimmunity is implicated, B-cell roles in TAK pathogenesis are increasingly recognized.

Observation:

• A 34-year-old male patient with TAK exhibited refractoriness to multiple biologic agents, including abatacept, tocilizumab, infliximab, and etanercept.
• This patient achieved sustained remission following treatment with rituximab (RTX), a B-cell depleting therapy.

Findings:

• Rituximab (RTX) therapy led to successful remission in a patient with Takayasu arteritis refractory to four prior biologic treatments.
• The patient required six courses of RTX, allowing for successful tapering of prednisolone and methotrexate without relapse.

Implications:

• This case suggests rituximab (RTX) is a potential therapeutic option for refractory Takayasu arteritis (TAK).
• Further validation of RTX efficacy in TAK requires controlled clinical trials.