Abstract
Introduction: Giant cell arteritis and Takayasu arteritis are the two major forms of idiopathic large vessel vasculitis. High doses of glucocorticoids are effective in inducing remission in both conditions, but relapses and recurrences are common, requiring prolonged glucocorticoid treatment with the risk of the related adverse events. Areas covered: In this article, we will review the standard and biological treatment strategies in large vessel vasculitis, and we will focus on the current approaches to these diseases. Expert commentary: The results of treatment trials with conventional immunosuppressive agents such as methotrexate, azathioprine, mycophenolate mofetil, and cyclophosphamide have overall been disappointing. TNF-α blockers are ineffective in giant cell arteritis, while observational evidence and a phase 2 randomized trial support the use of tocilizumab in relapsing giant cell arteritis. Observational evidence strongly supports the use of anti-TNF-α agents and tocilizumab in Takayasu patients with relapsing disease. However biological agents are not curative, and relapses remain common.
| Original language | English |
|---|---|
| Pages (from-to) | 345-360 |
| Number of pages | 16 |
| Journal | Expert Review of Clinical Immunology |
| Volume | 13 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 3 2017 |
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Keywords
- anti-TNF-α
- biological agents
- giant cell arteritis
- immunosuppressive agents
- Large vessel vasculitis
- Takayasu arteritis
- tocilizumab
- treatment
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
Cite this
Standard and biological treatment in large vessel vasculitis : guidelines and current approaches. / Muratore, Francesco; Pipitone, Nicolò; Salvarani, Carlo.
In: Expert Review of Clinical Immunology, Vol. 13, No. 4, 03.04.2017, p. 345-360.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Standard and biological treatment in large vessel vasculitis
T2 - guidelines and current approaches
AU - Muratore, Francesco
AU - Pipitone, Nicolò
AU - Salvarani, Carlo
PY - 2017/4/3
Y1 - 2017/4/3
N2 - Introduction: Giant cell arteritis and Takayasu arteritis are the two major forms of idiopathic large vessel vasculitis. High doses of glucocorticoids are effective in inducing remission in both conditions, but relapses and recurrences are common, requiring prolonged glucocorticoid treatment with the risk of the related adverse events. Areas covered: In this article, we will review the standard and biological treatment strategies in large vessel vasculitis, and we will focus on the current approaches to these diseases. Expert commentary: The results of treatment trials with conventional immunosuppressive agents such as methotrexate, azathioprine, mycophenolate mofetil, and cyclophosphamide have overall been disappointing. TNF-α blockers are ineffective in giant cell arteritis, while observational evidence and a phase 2 randomized trial support the use of tocilizumab in relapsing giant cell arteritis. Observational evidence strongly supports the use of anti-TNF-α agents and tocilizumab in Takayasu patients with relapsing disease. However biological agents are not curative, and relapses remain common.
AB - Introduction: Giant cell arteritis and Takayasu arteritis are the two major forms of idiopathic large vessel vasculitis. High doses of glucocorticoids are effective in inducing remission in both conditions, but relapses and recurrences are common, requiring prolonged glucocorticoid treatment with the risk of the related adverse events. Areas covered: In this article, we will review the standard and biological treatment strategies in large vessel vasculitis, and we will focus on the current approaches to these diseases. Expert commentary: The results of treatment trials with conventional immunosuppressive agents such as methotrexate, azathioprine, mycophenolate mofetil, and cyclophosphamide have overall been disappointing. TNF-α blockers are ineffective in giant cell arteritis, while observational evidence and a phase 2 randomized trial support the use of tocilizumab in relapsing giant cell arteritis. Observational evidence strongly supports the use of anti-TNF-α agents and tocilizumab in Takayasu patients with relapsing disease. However biological agents are not curative, and relapses remain common.
KW - anti-TNF-α
KW - biological agents
KW - giant cell arteritis
KW - immunosuppressive agents
KW - Large vessel vasculitis
KW - Takayasu arteritis
KW - tocilizumab
KW - treatment
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UR - http://www.scopus.com/inward/citedby.url?scp=85014941334&partnerID=8YFLogxK
U2 - 10.1080/1744666X.2017.1285699
DO - 10.1080/1744666X.2017.1285699
M3 - Review article
AN - SCOPUS:85014941334
VL - 13
SP - 345
EP - 360
JO - Expert Review of Clinical Immunology
JF - Expert Review of Clinical Immunology
SN - 1744-666X
IS - 4
ER -