Biological treatments in giant cell arteritis &amp; Takayasu arteritis

Samson, Maxime; Espígol‐Frigolé, Georgina; Terrades-García, Nekane; Prieto-González, Sergio; Corbera-Bellalta, Marc; Alba-Rovira, Roser; Hernández‐Rodríguez, José; Audia, Sylvain; Bonnotte, Bernard; Cid, María C.

doi:10.1016/j.ejim.2017.11.003

Cited by 40 publications

(52 citation statements)

References 89 publications

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“…1a. NIH scales also significantly decreased between baseline and 6 months of tocilizumab therapy (3 [3][4] at baseline versus 1 [0-2] at 6 months; p < 0.001), as well as ITAS-2010 (5 [2-7] versus 3 [0-8]; p = 0.002), and ITAS-A score (7 [4-10] versus 4 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]; p = 0.0001). Baseline practitioners' subjective scale evaluated that 13 patients (100%) had active TAK, versus 2 patients (15%) after 6 months (p < 0.001) ( Table 1).…”

Section: Efficacy Of Tocilizumab At 6 Monthsmentioning

confidence: 99%

“…Rapid and sustained remission under tocilizumab therapy has been described, notably among patients with refractory TAK [8][9][10][11][12][13]. These findings should be interpreted with caution, as most studies were case reports or small series, and vascular progression under tocilizumab treatment has also been described [8][9][10][11][12][13]. A recent randomized trial failed to demonstrate the benefit of tocilizumab, compared to placebo, on relapse-free survival among patients with refractory TAK [14].…”

Section: Introductionmentioning

confidence: 99%

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Tocilizumab in treatment-naïve patients with Takayasu arteritis: TOCITAKA French prospective multicenter open-labeled trial

et al. 2020

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Objectives To assess long-term efficacy of tocilizumab in treatment-naive patients with Takayasu arteritis (TAK). Methods Prospective open-labeled trial in naïve patients with TAK who received steroids at the dose of 0.7 mg/kg/day and 7 infusions of 8 mg/kg/month of tocilizumab. The primary endpoint was the number of patients who discontinued steroids after 7 infusions of tocilizumab. Secondary endpoints included disease activity and the number of relapses during 18-month follow-up. Results Thirteen patients with TAK were included, with a median age of 32 years [19–45] and 12 (92%) females. Six (54%) patients met the primary end-point. A significant decrease of disease activity was observed after 6 months of tocilizumab therapy: decrease of median NIH scale (3 [3, 4] at baseline, versus 1 [0–2] after 6 months; p < 0.001), ITAS-2010 score (5 [2–7] versus 3 [0–8]; p = 0.002), and ITAS-A score (7 [4–10] versus 4 [1–15]; p = 0.0001)]. During the 12-month follow-up after tocilizumab discontinuation, a relapse occurred among 5 patients (45%) out of 11 in which achieved remission after 6 months of tocilizumab. Conclusion Tocilizumab seems an effective steroid sparing therapy in TAK, but maintenance therapy is necessary. Trial registration ClinicalTrials.gov NCT02101333. Registered on 02 April 2014.

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Section: Efficacy Of Tocilizumab At 6 Monthsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tocilizumab in treatment-naïve patients with Takayasu arteritis: TOCITAKA French prospective multicenter open-labeled trial

et al. 2020

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“…Patients undergoing steroid therapy signi cantly decreased between baseline (13 patients, 100%) and 6 months of tocilizumab therapy (6 patients, 54%, p = 0.015), as shown in Figure 1A. NIH scales also signi cantly decreased between baseline and 6 months of tocilizumab therapy (3 [3][4] [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]; p=0.0001). Baseline practitioners' subjective scale evaluated that 13 patients (100%) had active TAK, versus 2 patients (15%) after 6 months (p <0.001) ( Table 1).…”

Section: Patient Characteristicsmentioning

confidence: 96%

“…Rapid and sustained remission under tocilizumab therapy has been described, notably among patients with refractory TAK [8][9][10][11][12][13] . These ndings should be interpreted with caution, as most studies were casereports or small series, and vascular progression under tocilizumab treatment has also been described [8][9][10][11][12][13] . A recent randomized trial failed to demonstrate the bene t of tocilizumab, compared to placebo, on relapse-free survival among patients with refractory TAK 14 .…”

Section: Introductionmentioning

confidence: 99%

Tocilizumab in treatment-naïve patients with Takayasu arteritis: TOCITAKA French prospective multicenter open-labelled trial

Mékinian¹,

Saadoun²,

Vicaut

et al. 2020

Preprint

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ObjectivesTo assess long term efficacy of tocilizumab in treatment-naive patients with Takayasu arteritis (TAK).MethodsProspective open-labelled trial in naïve patients with TAK who received steroids at the dose of 0.7 mg/kg/day and 7 infusions of 8 mg/kg/month of tocilizumab. The primary endpoint was the number of patients which discontinued steroids after 7 infusions of tocilizumab. Secondary endpoints included disease activity and the number of relapses during an 18-month follow-up.ResultsThirteen patients with TAK were included, with a median age of 32 years [19-45] and 12 (92%) females. Six (54%) patients met the primary end-point. A significant decrease of disease activity was observed after 6 months of tocilizumab therapy: decrease of median NIH scale (3 [3-4] at baseline, versus 1 [0-2] after 6 months; p <0.001), ITAS-2010 score (5 [2-7] versus 3 [0-8]; p = 0.002), and ITAS-A score (7 [4-10] versus 4 [1-15]; p = 0.0001)]. During the 12 months follow-up after tocilizumab discontinuation, a relapse occurred among 5 patients (45%) out of 11 in which achieved remission after 6 months of tocilizumab.ConclusionTocilizumab seems an effective steroid sparing therapy in TAK but maintenance therapy is necessary.

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“…Interestingly, some genes associated with TAK are being explored as therapeutic targets for this vasculitis. On one hand, tocilizumab, a humanized monoclonal antibody against IL-6 receptor (IL-6R), has shown clinical efficacy in TAK patients in several case series studies (59). This efficiency was confirmed in a prospective clinical trial evaluating tocilizumab in refractory TAK, although the primary end-point was not met, probably due to the low number of individuals included in this study (60).…”

Section: Contribution Of Genetics To New Therapeutic Approaches In Vamentioning

confidence: 99%

Leveraging Genetic Findings for Precision Medicine in Vasculitis

2019

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Vasculitides are a heterogeneous group of low frequent disorders, mainly characterized by the inflammation of blood vessels that narrows or occlude the lumen and limits the blood flow, leading eventually to significant tissue and organ damage. These disorders are classified depending on the size of the affected blood vessels in large, medium, and small vessel vasculitis. Currently, it is known that these syndromes show a complex etiology in which both environmental and genetic factors play a major role in their development. So far, these conditions are not curable and the therapeutic approaches are mainly symptomatic. Moreover, a percentage of the patients do not adequately respond to standard treatments. Over the last years, numerous genetic studies have been carried out to identify susceptibility loci and biological pathways involved in vasculitis pathogenesis as well as potential genetic predictors of treatment response. The ultimate goal of these studies is to identify new therapeutic targets and to improve the use of existing drugs to achieve more effective treatments. This review will focus on the main advances made in the field of genetics and pharmacogenetics of vasculitis and their potential application for ameliorating long-term outcomes in patient management and in the development of precision medicine.

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Biological treatments in giant cell arteritis & Takayasu arteritis

Cited by 40 publications

References 89 publications

Tocilizumab in treatment-naïve patients with Takayasu arteritis: TOCITAKA French prospective multicenter open-labeled trial

Tocilizumab in treatment-naïve patients with Takayasu arteritis: TOCITAKA French prospective multicenter open-labeled trial

Tocilizumab in treatment-naïve patients with Takayasu arteritis: TOCITAKA French prospective multicenter open-labelled trial

Leveraging Genetic Findings for Precision Medicine in Vasculitis

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