Successful Use of Tofacitinib in Refractory Takayasu Arteritis: A Case Series

To study the clinical effectiveness and safety of Tofacitinib in refractory Takayasu arteritis (TAK).

This study was conducted from September 2021 to June 2022. Ten cases of refractory TAK patients were enrolled. TAK patients who required >7.5mg prednisolone or equivalent per day and those who failed to achieve remission despite being on conventional immunomodulators, with an Indian Takayasu Activity Score 2010 (ITAS 2010) of > 1 were included in this study. Tofacitinib was used at a dose of 5 mg twice daily after ruling out latent tuberculosis. The patients were followed up at 1, 3 and 6 months. ESR, CRP and ITAS 2010 were recorded at each visit. Complete blood counts, liver, and kidney function tests were done to assess the adverse effects at baseline and follow up.

There was a mean decline in ESR from 60.7 ± 20.05 mm/1^st hour at baseline to 11.9 ± 2.38mm/1^st hour at 6 months, CRP from 28.9 ± 16.77 mg/L at baseline to 6.8 ± 7.52 mg/L at 6 months, ITAS 2010 from 6.2 ± 2.74 at baseline to 0.6 ± 1.26 at 6 months (p value 0.016). All the patients tolerated tofacitinib well without any adverse effects.

The results of our research indicate that tofacitinib is safe and effective for treating patients with refractory TAK.