Efficacy of tocilizumab in Takayasu arteritis: Multicenter retrospective study of 46 patients
Arsene Mekinian
(1, 2)
,
Mathieu Resche-Rigon
(3)
,
Cloé Comarmond
(4, 2)
,
Alessandra Soriano
(5)
,
Joël Constans
(6)
,
Laurent Alric
(7)
,
Patrick Jego
(8)
,
Florian Busato
(9)
,
Matthieu Cabon
(10)
,
Robin Dhote
(11)
,
Lazaro Estibaliz
(12)
,
Isabelle Koné-Paut
(13, 14)
,
Cédric Landron
(15)
,
Christian Lavigne
(16)
,
Bertrand Lioger
(17)
,
Martin Michaud
(18)
,
Marc Ruivard
(19, 20)
,
Karim Sacre
(21)
,
Jacques Eric Gottenberg
(10)
,
Francis Gaches
(19, 20)
,
Tiphaine Goulenok
(21)
,
Carlo Salvaranin
(5)
,
Patrice Cacoub
(4, 2)
,
Olivier Fain
(1, 2)
,
David Saadoun
(22, 2)
1
CHU Saint-Antoine [AP-HP]
2 I3 - Immunologie - Immunopathologie - Immunothérapie [CHU Pitié Salpêtrière]
3 Biostatistique et épidemiologie clinique
4 CHU Pitié-Salpêtrière [AP-HP]
5 UNIMORE - Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia
6 Hôpital Saint-André
7 PHARMA-DEV - Pharmacochimie et Biologie pour le Développement
8 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
9 Centre Hospitalier de Bigorre [Tarbes]
10 Service de rhumatologie [Strasbourg]
11 Service de médecine interne [Avicenne]
12 Hôpital Haut-Lévêque [CHU Bordeaux]
13 Service de Pédiatrie Générale et Rhumatologie Pédiatrique
14 CeRéMAIA - Centre de Référence des Maladies Auto-Inflammatoires et des Amyloses [Le Kremlin-Bicêtre]
15 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
16 CHU Angers - Centre Hospitalier Universitaire d'Angers
17 AP-HP - Hopital Saint-Louis [AP-HP]
18 HJD - Hôpital Joseph Ducuing - Varsovie [Toulouse]
19 CHU Estaing [Clermont-Ferrand]
20 IP - Institut Pascal
21 Service de Médecine Interne
22 INSERM - Institut National de la Santé et de la Recherche Médicale
2 I3 - Immunologie - Immunopathologie - Immunothérapie [CHU Pitié Salpêtrière]
3 Biostatistique et épidemiologie clinique
4 CHU Pitié-Salpêtrière [AP-HP]
5 UNIMORE - Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia
6 Hôpital Saint-André
7 PHARMA-DEV - Pharmacochimie et Biologie pour le Développement
8 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
9 Centre Hospitalier de Bigorre [Tarbes]
10 Service de rhumatologie [Strasbourg]
11 Service de médecine interne [Avicenne]
12 Hôpital Haut-Lévêque [CHU Bordeaux]
13 Service de Pédiatrie Générale et Rhumatologie Pédiatrique
14 CeRéMAIA - Centre de Référence des Maladies Auto-Inflammatoires et des Amyloses [Le Kremlin-Bicêtre]
15 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
16 CHU Angers - Centre Hospitalier Universitaire d'Angers
17 AP-HP - Hopital Saint-Louis [AP-HP]
18 HJD - Hôpital Joseph Ducuing - Varsovie [Toulouse]
19 CHU Estaing [Clermont-Ferrand]
20 IP - Institut Pascal
21 Service de Médecine Interne
22 INSERM - Institut National de la Santé et de la Recherche Médicale
Arsene Mekinian
- Fonction : Auteur
- PersonId : 818189
- ORCID : 0000-0003-2849-3049
- IdRef : 131898493
Cloé Comarmond
- Fonction : Auteur
- PersonId : 955435
Karim Sacre
- Fonction : Auteur
- PersonId : 770565
- ORCID : 0000-0002-6544-234X
Patrice Cacoub
- Fonction : Auteur
- PersonId : 976717
Olivier Fain
- Fonction : Auteur
- PersonId : 1166060
- ORCID : 0000-0002-1974-3870
- IdRef : 069538476
David Saadoun
- Fonction : Auteur
- PersonId : 759697
- ORCID : 0000-0003-3628-9996
- IdRef : 119038765
Résumé
Objectives
To assess the efficacy of tocilizumab in patients with Takayasu arteritis (TA).
Methods
We conducted a retrospective multicenter study in 46 TA patients treated with tocilizumab. We analyzed factors associated with response to tocilizumab (assessed using NIH score).
Results
Forty-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).
Conclusion
This large multicenter study shows that tocilizumab is efficient and may reduce the incidence of relapses in TA.
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