Rescue treatment with tocilizumab for takayasu arteritis resistant to TNF-α blockers

C. Salvarani, L. Magnani, M. Catanoso, N. Pipitone, A. Versari, L. Dardani, L. Pulsatelli, R. Meliconi, L. Boiardi

Research output: Contribution to journalArticle

Abstract

Anti-TNF-α therapy has successfully been used to treat Takayasu arteritis (TA) refractory to conventional immunosuppressive treatment. However, some patients fail to respond even to TNF-α blockers. Interleukin-6 (IL-6) is a key player in the pathogenesis of TA. Preliminary data also suggest efficacy of the IL-6 receptor inhibitor tocilizumab in patients with large-vessel vasculitis. We report a patient with TA refractory to multiple conventional immunosuppressive agents and two TNF-α blockers successfully treated with monthly tocilizumab infusions (8 mg/kg body weight) for 6 consecutive months. Clinical indices of disease activity, inflammatory markers, and 18F-fluorodeoxyglucose positron emission/computerised tomography findings normalised, while the prednisone dosage could be tapered. Serum IL-6 and soluble IL-6 receptor (sIL-6R) levels raised during tocilizumab treatment consistent with the mode of action of tocilizumab. Tocilizumab holds promise for patients with refractory TA. Larger studies are required to confirm our findings.

Original languageEnglish
JournalClinical and Experimental Rheumatology
Volume30
Issue numberSUPPL. 70
Publication statusPublished - 2012

Keywords

  • Inhibitors
  • Interleukin-6
  • Takayasu arteritis
  • TNF-α
  • Tocilizumab

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

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