Intravenous versus subcutaneous tocilizumab in Takayasu arteritis: multicentre retrospective study.

In this large multicentre study, we compared the effectiveness and safety of tocilizumab intravenous versus subcutaneous (SC) in 109 Takayasu arteritis (TAK) patients. We conducted a retrospective multicentre study in referral centres from France, Italy, Spain, Armenia, Israel, Japan, Tunisia and Russia regarding biological-targeted therapies in TAK, since January 2017 to September 2019. A total of 109 TAK patients received at least 3 months tocilizumab therapy and were included in this study. Among them, 91 and 18 patients received intravenous and SC tocilizumab, respectively. A complete response (NIH <2 with less than 7.5 mg/day of prednisone) at 6 months was evidenced in 69% of TAK patients, of whom 57 (70%) and 11 (69%) patients were on intravenous and SC tocilizumab, respectively (p=0.95). The factors associated with complete response to tocilizumab at 6 months in multivariate analysis, only age <30 years (OR 2.85, 95% CI 1.14 to 7.12; p=0.027) and time between TAK diagnosis and tocilizumab initiation (OR 1.18, 95% CI 1.02 to 1.36; p=0.034). During the median follow-up of 30.1 months (0.4; 105.8) and 10.8 (0.1; 46.4) (p<0.0001) in patients who received tocilizumab in intravenous and SC forms, respectively, the risk of relapse was significantly higher in TAK patients on SC tocilizumab (HR=2.55, 95% CI 1.08 to 6.02; p=0.033). The overall cumulative incidence of relapse at 12 months in TAK patients was at 13.7% (95% CI 7.6% to 21.5%), with 10.3% (95% CI 4.8% to 18.4%) for those on intravenous tocilizumab vs 30.9% (95% CI 10.5% to 54.2%) for patients receiving SC tocilizumab. Adverse events occurred in 14 (15%) patients on intravenous route and in 2 (11%) on SC tocilizumab. In this study, we confirm that tocilizumab is effective in TAK, with complete remission being achieving by 70% of disease-modifying antirheumatic drugs-refractory TAK patients at 6 months. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Arsène Mekinian, Lucie Biard, Dagna Lorenzo, Pavel I Novikov, Carlo Salvarani, Olivier Espitia, Savino Sciascia, Martin Michaud, Marc Lambert, José Hernández-Rodríguez, Nicolas Schleinitz, Abid Awisat, Xavier Puechal, Achille Aouba, Helene Munoz Pons, Ilya Smitienko, Jean Baptiste Gaultier, Le Mouel Edwige, Ygal Benhamou, Antoinette Perlat, Patrick Jego, Tiphaine Goulenok, Karim Sacre, Bertrand Lioger, Nolan Hassold, Jonathan Broner, Virginie Dufrost, Thomas Sené, Julie Seguier, Francois Maurier, Sabine Berthier, Alexandre Belot, Faten Frikha, Guillaume Denis, Alexandra Audemard-Verger, Isabelle Koné-Paut, Sebastien Humbert, Pascal Woaye-Hune, Alessandro Tomelleri, Elena Marina Baldissera, Masataka Kuwana, Alberto Lo Gullo, Vahan Mukuchyan, Azeddine Dellal, Francis Gaches, Pierre Zeminsky, Elena Galli, Moya Alvarado, Luigi Boiardi, Francesco Muratore, Mathieu Vautier, Corrado Campochiaro, Sergey Moiseev, Matheus Vieira, Patrice Cacoub, Olivier Fain, David Saadoun, French Takayasu network. Intravenous versus subcutaneous tocilizumab in Takayasu arteritis: multicentre retrospective study. RMD open. 2023 Jun;9(2)

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PMID: 37321669

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