Rituximab therapy for Takayasu arteritis: A seven patients experience and a review of the literature

Giulia Pazzola, Francesco Muratore, Nicoló Pipitone, Filippo Crescentini, Patrice Cacoub, Luigi Boiardi, Lucia Spaggiari, Cloe Comarmond, Stefania Croci, David Saadoun, Carlo Salvarani

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives. To assess the efficacy and safety of rituximab (RTX) in patients with Takayasu arteritis (TAK). Methods. We conducted a retrospective study on seven TAK patients treated with RTX. Six of the seven patients had a disease refractory to high dose glucocorticoids and conventional immunosuppressive and/ or biologic agents. One newly diagnosed, treatment-naïve TAK patient refused glucocorticoids and received RTX alone. Clinical evaluation, laboratory tests and imaging modalities (CT or MR-angiography, and 18F-fluorodeoxyglucose PET/CT) were performed at first RTX administration and every 6 months thereafter. Disease activity was assessed using the Kerr index. We also performed a literature review using PubMed, Ovid MEDLINE and Cochrane library. Results. Seven patients (6 females) were included in the study. Mean (S.D.) age was 32.4 (17.3) years. At first RTX administration, all patients had active disease according to the Kerr index (≥), and had also evidence of active disease at PET/CT. Despite RTX treatment, four of the seven patients had evidence of persistent disease activity and/or radiographic disease progression during follow-up. Three out of seven patients in whom RTX was employed as rescue therapy achieved complete remission. In the literature review, we identified five papers describing nine patients treated with RTX with good results in eight cases, but short follow-up. Conclusion. Our data do not support a role for RTX as first line biologic therapy in TAK patients, but it may have a role in some patients as second or third line biologic therapy.

Original languageEnglish
Pages (from-to)1151-1155
Number of pages5
JournalRheumatology (United Kingdom)
Volume57
Issue number7
DOIs
Publication statusPublished - Jul 1 2018
Externally publishedYes

Keywords

  • Disease activity
  • Rituximab
  • Takayasu arteritis

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

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