Takayasu's arteritis occurring under TNF-α blockers: a new paradoxical effect?

Souabni, L.; Abdelghani, K. Ben; Jradi, S.; Zakraoui, L.

doi:10.1136/bcr-2014-204226

Cited by 11 publications

(6 citation statements)

References 13 publications

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“…Some authors [ 6 – 8 ] reported cases of TA arising under TNFi therapy and propose a causal effect of the TNFi use on TA development. Others describe aortitis occurring under TNFi therapy [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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Takayasu’s arteritis occurring under TNF blockers in a patient with spondyloarthritis: is it an association or a paradoxical effect?

Rezgui¹,

Thabet²,

Makki³

et al. 2021

Reumatologia

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Coexistence of spondyloarthritis (SpA) and Takayasu’s arteritis is not a common finding, but such cases have been discussed, particularly in the context of choice of therapy. Inhibition of inflammation by tumor necrosis factor inhibitors (TNFi) is a key aspect of the treatment of SpA and also positive effects of such treatment in concomitant large vessel vasculitis have been reported. However, TNFi is also associated with the possibility of initiating vasculitis. The present article based on a case study and the available literature is an attempt to discuss coexistence of these two diseases and the impact of treatment with biological drugs from the anti-TNF group in the course of SpA with Takayasu’s arteritis.

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Section: Discussionmentioning

confidence: 99%

“…The mechanism of this paradoxical side effect remains unclear and we still cannot determine the contribution of TNFi to the development of vasculitis. Nevertheless, this phenomenon might be related to immune complexes containing the drug which may be deposited on vessel walls in a disturbed immune homeostasis [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Takayasu’s arteritis occurring under TNF blockers in a patient with spondyloarthritis: is it an association or a paradoxical effect?

Rezgui¹,

Thabet²,

Makki³

et al. 2021

Reumatologia

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“…1 There are also reports of granulomatous large vessel vasculitis such as Takayasu arteritis. 2 Reports of TNF inhibitor-induced sarcoidosis indicate a link between TNF inhibitors and granulomatous inflammation. 3 In the central nervous system, a relationship between vascular amyloid deposits and granulomatous vasculitis has been suggested.…”

mentioning

confidence: 99%

Infliximab-Induced Granulomatous Vasculitis With Amyloid Deposition in the Tongue of a Patient With Behçet Disease

et al. 2020

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“…10 Although anti-TNF agents are used in treatment of TA, interestingly, there are case reports of TA developing after initiation of these agents in the literature. [11][12][13] In these case reports, two patients with spondyloarthritis, one patient with rheumatoid arthritis, and one patient with Crohn's disease developed TA after treatment with anti-TNF agents. This paradoxical effect may be due to the presence of different pathophysiologic pathways in a subgroup of patients with TA.…”

mentioning

confidence: 99%

Certolizumab Pegol Treatment in Three Patients With Takayasu Arteritis

et al. 2019

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Takayasu arteritis (TA) is a rare granulomatous large vessel vasculitis which primarily affects aorta and its major branches. TA can result in stenosis, occlusion, aneurysm formation, and dilatation of effected vessels. 1 Females are predominantly affected with an age of onset of ≤40 years. 2 Although its distribution is worldwide, it generally affects Asian populations. TA is relatively uncommon in northern European and American populations. 3 Although the etiology of TA is unknown, cell-mediated autoimmunity and genetic factors have an important role in the pathogenesis of TA. 4 Clinical manifestations are determined by the affected vessels and degree of inflammation. 5 TA generally progresses through three different phases. In the first prevasculitic phase, patients complain of nonspecific constitutional symptoms such as fever, fatigue, and malaise. In the second inflammatory phase, vascular pain (particularly carotidynia) tends to occur. The third burnedout phase is characterized with arterial bruits, decreased or absence of pulses and/or differences in arterial blood pressure between upper extremities, claudication in the legs and ischemic symptoms. 6 An overlap may be observed between these phases. There is no gold standard laboratory test and imaging method for diagnosis of TA. The American College of Rheumatology (ACR) criteria are the most widely used vasculitis classification criteria. 7 The main target of treatment in TA is to suppress the inflammatory process. Management of cardiovascular risk factors such as dyslipidemia, smoking, and hypertension is also important. Corticosteroids (CS) are the mainstay of therapy. Methotrexate (MTX), azathioprine (AZA), cyclosporine, tacrolimus, mycophenolate mofetil,

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Takayasu's arteritis occurring under TNF-α blockers: a new paradoxical effect?

Cited by 11 publications

References 13 publications

Takayasu’s arteritis occurring under TNF blockers in a patient with spondyloarthritis: is it an association or a paradoxical effect?

Takayasu’s arteritis occurring under TNF blockers in a patient with spondyloarthritis: is it an association or a paradoxical effect?

Infliximab-Induced Granulomatous Vasculitis With Amyloid Deposition in the Tongue of a Patient With Behçet Disease

Certolizumab Pegol Treatment in Three Patients With Takayasu Arteritis

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