Tocilizumab for the Treatment of Patients With Refractory Takayasu Arteritis
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概要
- 論文の詳細を見る
Treatment of refractory Takayasu arteritis (TA) remains an unresolved clinical issue. Patients usually respond to glucocorticoid (GC) therapy, but often relapse on tapering of the GC dose. The aim of the present study was to assess the safety and efficacy of the interleukin-6 (IL-6) receptor antibody tocilizumab (TCZ) in patients with TA refractory to conventional therapies including GC. Four patients with TA who had shown GC resistance received TCZ infusions (8 mg/kg) every 4 weeks a total of at least 24 times (range, 24 to 51). Clinical symptoms, the serum levels of acute phase proteins and IL-6, GC dosage necessary to maintain remission, and cross-sectional imaging by enhanced CT and MRI were assessed. All patients achieved good clinical response and rapid normalization of the acute phase proteins such as C-reactive protein and serum amyloid A during the therapy with TCZ. The mean dosage of prednisolone could be reduced from 21.3 mg/day to 1.5 mg/day. Although the serum IL-6 level was transiently elevated in all patients after several TCZ infusions, it gradually recovered to the initial level. Along with the decrease of serum IL-6, two patients exhibited signifi cant reduction in thickened arterial lesions. No drug-related adverse effects were noted. In this small group of patients with refractory TA, TCZ therapy was effective and well-tolerated. Further larger studies should be conducted to confirm this finding.
- International Heart Journal刊行会の論文
著者
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Ikeoka Kuniyasu
Department of Cardiology, Knasai Rosai Hospital
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Sakata Yasushi
Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine
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HIGUCHI Kaori
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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ARITA Yoh
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Higuchi Kaori
Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine
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Ohtani Tomohito
Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine
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Yasui Taku
Deparment of Cardiology, Osaka General Medical Center
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Nakaoka Yoshikazu
Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine
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Otsuki Michio
Department Of Medicine Osaka University Graduate School Of Medicine
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Yamamoto Kaori
Department Of Chemistry Faculty Of Science Toyama University
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Shima Yoshihito
Department Of Respiratory Medicine Allergy And Rheumatic Disease Osaka University Graduate School Of
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Kumanogoh Atsushi
Department Of Immunopathology Immunology Frontier Research Center (ifrec) Research Institute For Mic
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Tanaka Toshio
Department Of Applied Physics Faculty Of Engineering Tokyo University
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Komuro Issei
Department Of Cardiovascular Medicine
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KISHIMOTO Tadamitsu
Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine
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Nakaoka Yoshikazu
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Tanaka Toshio
Department of Clinical Application of Biologics, Osaka University Graduate School of Medicine
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Yamauchi-Takihara Keiko
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Hashimoto-Kataoka Takahiro
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Yamamoto Kaori
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Shima Yoshihito
Department of Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine
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Sakata Yasushi
Department of Applied Chemistry, Faculty of Engineering, Doshisha University
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Tanaka Toshio
Department of Applied Chemistry, Faculty of Engineering, Osaka Univeristy
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Kishimoto Tadamitsu
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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