TY - JOUR
T1 - Tocilizumab
T2 - A novel therapy for patients with large-vessel vasculitis
AU - Salvarani, Carlo
AU - Magnani, Luca
AU - Catanoso, Mariagrazia
AU - Pipitone, Nicoló
AU - Versari, Annibale
AU - Dardani, Lucia
AU - Pulsatelli, Lia
AU - Meliconi, Riccardo
AU - Boiardi, Luigi
PY - 2012/1
Y1 - 2012/1
N2 - Objective: Treatment of large-vessel vasculitis (LVV) remains challenging. Patients usually respond to glucocorticoid (GC) therapy, but often relapse on tapering of the GC dose or after GC withdrawal. In addition, GCs are fraught with numerous adverse events. The aim of this study was to assess the efficacy and safety of the anti-IL-6 receptor (IL-6R) antibody tocilizumab (TCZ) in patients with LVV. Methods: Four patients with active LVV (two with GCA and two with Takayasu arteritis) received monthly TCZ infusions (8 mg/kg bodyweight) for 6 consecutive months. Two patients were treatment nai{dotless}̈ve, while two had relapsing disease. Disease activity and drug tolerability were assessed clinically and by laboratory tests at study entry and subsequently every month for 6 months of TCZ treatment, while an [ 18F]fluorodeoxyglucose PET (PET/CT) scan was performed before and after treatment. In addition, a semi-quantitative clinical evaluation was performed at baseline and at 3 and 6 months using the Indian Takayasu activity score and the Kerr indices. After TCZ, MTX was used as maintenance therapy. Results: All patients treated with TCZ therapy had a satisfactory clinical and laboratory response, while PET/CT findings significantly improved in all cases. No serious adverse events were noted. Only one patient had a transient increase in liver enzymes. Conclusions: In this small group of patients with LVV, treatment with TCZ was effective and well tolerated. Further, larger studies are required to confirm our findings.
AB - Objective: Treatment of large-vessel vasculitis (LVV) remains challenging. Patients usually respond to glucocorticoid (GC) therapy, but often relapse on tapering of the GC dose or after GC withdrawal. In addition, GCs are fraught with numerous adverse events. The aim of this study was to assess the efficacy and safety of the anti-IL-6 receptor (IL-6R) antibody tocilizumab (TCZ) in patients with LVV. Methods: Four patients with active LVV (two with GCA and two with Takayasu arteritis) received monthly TCZ infusions (8 mg/kg bodyweight) for 6 consecutive months. Two patients were treatment nai{dotless}̈ve, while two had relapsing disease. Disease activity and drug tolerability were assessed clinically and by laboratory tests at study entry and subsequently every month for 6 months of TCZ treatment, while an [ 18F]fluorodeoxyglucose PET (PET/CT) scan was performed before and after treatment. In addition, a semi-quantitative clinical evaluation was performed at baseline and at 3 and 6 months using the Indian Takayasu activity score and the Kerr indices. After TCZ, MTX was used as maintenance therapy. Results: All patients treated with TCZ therapy had a satisfactory clinical and laboratory response, while PET/CT findings significantly improved in all cases. No serious adverse events were noted. Only one patient had a transient increase in liver enzymes. Conclusions: In this small group of patients with LVV, treatment with TCZ was effective and well tolerated. Further, larger studies are required to confirm our findings.
KW - Giant cell arteritis
KW - Interleukin-6
KW - Large-vessel vasculitis
KW - Takayasu arteritis
KW - Tocilizumab
UR - http://www.scopus.com/inward/record.url?scp=84855162831&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84855162831&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/ker296
DO - 10.1093/rheumatology/ker296
M3 - Article
C2 - 22075063
AN - SCOPUS:84855162831
VL - 51
SP - 151
EP - 156
JO - Rheumatology
JF - Rheumatology
SN - 1462-0324
IS - 1
M1 - ker296
ER -