Intravenous versus subcutaneous tocilizumab in Takayasu arteritis: multicentre retrospective study

Area of Science:

• Rheumatology
• Immunology
• Internal Medicine

Background:

• Takayasu arteritis (TAK) is a rare, chronic inflammatory disease affecting large arteries.
• Tocilizumab, an interleukin-6 receptor inhibitor, is used to manage inflammatory conditions, including TAK.

Purpose of the Study:

• To compare the effectiveness and safety of intravenous versus subcutaneous tocilizumab in patients with Takayasu arteritis.
• To identify factors associated with treatment response and evaluate relapse rates.

Main Methods:

• A retrospective multicenter study involving 109 Takayasu arteritis patients treated with tocilizumab (intravenous or subcutaneous) for at least 3 months.
• Data collected from January 2017 to September 2019 across multiple international referral centers.

Main Results:

• A complete response at 6 months was observed in 69% of patients, with no significant difference between intravenous (70%) and subcutaneous (69%) tocilizumab.
• Younger age (<30 years) and shorter time between diagnosis and treatment initiation were associated with complete response.
• The risk of relapse was significantly higher with subcutaneous tocilizumab (HR=2.55, p=0.033), with a 12-month cumulative incidence of 30.9% versus 10.3% for intravenous administration.

Conclusions:

• Tocilizumab is effective in treating Takayasu arteritis, achieving complete remission in 70% of refractory patients at 6 months.
• Intravenous administration of tocilizumab is associated with a lower risk of relapse compared to subcutaneous administration in TAK patients.