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Tocilizumab treatment effectively improves coronary artery involvement in patients with Takayasu arteritis

Lili Pan1, Juan Du1, Jiayi Liu2

  • 1Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Clinical Rheumatology
|March 8, 2020
PubMed

Insights

Tocilizumab (TCZ) effectively reduced disease activity and improved coronary artery lesions in Takayasu arteritis (TAK) patients. This treatment also significantly lowered glucocorticoid dosage and improved imaging findings, offering a promising therapeutic option for TAK.

Area of Science:

  • Rheumatology
  • Immunology
  • Cardiology

Background:

  • Coronary artery involvement in Takayasu arteritis (TAK) is associated with poor prognosis and high mortality.
  • Tocilizumab (TCZ), an interleukin-6 receptor inhibitor, has shown efficacy in treating large vessel vasculitis.
  • The effectiveness of TCZ in addressing coronary artery lesions specifically within TAK remains to be fully elucidated.

Purpose of the Study:

  • To retrospectively evaluate the efficacy of Tocilizumab (TCZ) in managing coronary artery involvement in patients diagnosed with Takayasu arteritis (TAK).

Main Methods:

  • A retrospective analysis compared clinical features and coronary artery lesion manifestations in 11 TAK patients before and after TCZ treatment.
  • A control group of 11 TAK patients treated with traditional disease-modifying antirheumatic drugs (DMARDs) was used for comparison.
  • Disease activity was assessed using C-reactive protein, erythrocyte sedimentation rate, Kerr score, and the Indian Takayasu Clinical Activity Score (ITAS) 2010 and ITAS-A.

Main Results:

  • TCZ treatment led to significant reductions in C-reactive protein, ESR, and Kerr score after 6 months.
  • Patients receiving TCZ demonstrated significantly lower ITAS 2010 and ITAS-A scores compared to those on traditional DMARDs.
  • TCZ treatment allowed for a significant reduction in glucocorticoid (GC) dosage and showed improvement in coronary artery lesion imaging findings, including reduced lesion count and vascular wall thickening.

Conclusions:

  • Tocilizumab (TCZ) demonstrates potential in decreasing disease activity and improving coronary artery lesions in Takayasu arteritis (TAK) patients.
  • TCZ treatment is associated with a significant reduction in glucocorticoid (GC) dosage requirements.
  • Improvements in imaging findings suggest TCZ can positively impact vascular manifestations in TAK.
Abstract

Keywords:
Coronary arteryTakayasu arteritisTocilizumabTreatment

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