Circulatory histidine levels as predictive indicators of disease activity in takayasu arteritis

Objectives:To assess long term efficacy of tocilizumab in treatment-naive patients with Takayasu arteritis (TAK).Methods:In this multicenter, prospective, open-labelled trial, we aim to evaluate the benefit of adding tocilizumab to steroids in treatment-naïve patients with TAK, on discontinuation of steroids after 6 months of tocilizumab treatment, and to assess relapse-free survival following tocilizumab discontinuation.Results:Thirteen patients with TAK were included, with a median age of 32 years [19-45] and 12 (92%) females. Six (54%) patients met the primary end-point. Among 11 (85%) patients which achieved remission at 6 months, 6 (54%) have reached primary endpoint.. Among the 5 remaining patients which continued steroids, 3 had a prednisone-equivalent dosage < 5mg/day. A significant decrease of disease activity was observed after 6 months of tocilizumab therapy: decrease of median NIH scale (3 [3-4] at baseline, versus 1 [0-2] after 6 months; p <0.001), ITAS-2010 score (5 [2-7] versus 3 [0-8]; p = 0.002), and ITAS-A score (7 [4-10] versus 4 [1-15]; p = 0.0001)]. All patients discontinued tocilizumab after 7 infusions, and no other immunosuppressive drugs was introduced, except for 1 patient which received methotrexate. After 9 and 12 months, respectively 7 (54%) and 6 (50%) patients achieved remission with less than 7.5 mg/day of prednisone, and 9 (69%) and 9 (75%) with doses <10 mg/day. During the 12 months follow-up after tocilizumab discontinuation, a relapse occurred among 5 patients (45%) out of 11 in which achieved remission after 6 months of tocilizumab.No severe AEs were considered related to study treatment and none required tocilizumab interruption or dose reduction. No deaths have occurred during the study period.Conclusion:Tocilizumab seems an effective steroid sparing therapy in TAK but its effect appears to be suspensive.Disclosure of Interests:Arsene Mekinian: None declared, david Saadoun: None declared, [email protected] [email protected]: None declared, [email protected] [email protected]: None declared, Patrick Jégo: None declared, [email protected] [email protected]: None declared, wxv wxv: None declared, Jacques-Eric Gottenberg Grant/research support from: BMS, Pfizer, Consultant of: BMS, Sanofi-Genzyme, UCB, Speakers bureau: Abbvie, Eli Lilly and Co., Roche, Sanofi-Genzyme, UCB, Mathieu Vautier: None declared, [email protected]>; [email protected]>;: None declared, Patrice cacoub: None declared, olivier fain: None declared

Download Full-text

Serum C1q concentration is associated with disease activity in Chinese Takayasu arteritis patients: A case‐control study

Health Science Reports ◽

10.1002/hsr2.252 ◽

2021 ◽

Vol 4 (2) ◽

Author(s):

Si Chen ◽

Haixia Luan ◽

Jianxun He ◽

Yan Wang ◽

Xiaoli Zeng ◽

...

Keyword(s):

Disease Activity ◽

Takayasu Arteritis ◽

Case Control Study ◽

Case Control ◽

Control Study

Download Full-text

Clinical and doppler monitoring of patients with Takayasu arteritis with ITAS 2010 and CDUS-K score respectively following medical intervention: a 12 months follow-up study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20184415 ◽

2018 ◽

Vol 6 (11) ◽

pp. 3602

Author(s):

Debanjali Sinha ◽

Sumantro Mondal ◽

Arijit Nag ◽

Debasish Lahiri ◽

Alakendu Ghosh

Keyword(s):

Disease Activity ◽

Disease Progression ◽

Takayasu Arteritis ◽

Medical Intervention ◽

Matched Pair ◽

Rank Test ◽

Colour Doppler ◽

Signed Rank ◽

Signed Rank Test

Background: The objective of the present study was to monitor the disease activity of Takayasu arteritis clinically by the Indian Takayasu Activity Score 2010 (ITAS) and ultra sonographically by Colour Doppler Ultrasound-Kolkata (CDUS-K) Score after 12months of treatment with methotrexate and steroid, and to find the correlation between these two scores.Methods: Around 25 Angiographically proven Takayasu arteritis patients were treated with Methotrexate (15mg weekly) and Steroids (1mg/kg/day for 6weeks and then tapered) for 12months. Wilcoxon matched pair signed rank test was done to assess the change in ITAS 2010 with treatment. A correlation study was done between ITAS 2010 and change in CDUS-K scores at the end of 12months.Results: By Wilcoxon’s matched pair signed rank test, a non-significant change of ITAS 2010 (p=0.066) was observed at the end of 12months, which means that the treatment helps to control the disease progression by preventing a significant increase in ITAS 2010. Strong correlation (correlation coefficient of 0.878, 95% CI = 0.602 to 1.000) was found between the ITAS 2010 and change in CDUS-K scores at 12months follow up.Conclusions: The combination of Methotrexate and steroids helps to control the disease progression in Takayasu arteritis. Colour doppler ultrasonography may serve as a reliable and safe surrogate disease activity measure at follow up, as it avoids the radioactivity exposure and invasiveness of angiography.

Download Full-text

Tocilizumab in treatment-naïve patients with Takayasu arteritis: TOCITAKA French prospective multicenter open-labeled trial

Arthritis Research & Therapy ◽

10.1186/s13075-020-02311-y ◽

2020 ◽

Vol 22 (1) ◽

Cited By ~ 1

Author(s):

Arsene Mekinian ◽

◽

David Saadoun ◽

Eric Vicaut ◽

Sara Thietart ◽

...

Keyword(s):

Maintenance Therapy ◽

Disease Activity ◽

Primary Endpoint ◽

Takayasu Arteritis ◽

Number Of Patients ◽

Treatment Naïve ◽

Secondary Endpoints ◽

Steroid Sparing

Abstract Objectives To assess long-term efficacy of tocilizumab in treatment-naive patients with Takayasu arteritis (TAK). Methods Prospective open-labeled trial in naïve patients with TAK who received steroids at the dose of 0.7 mg/kg/day and 7 infusions of 8 mg/kg/month of tocilizumab. The primary endpoint was the number of patients who discontinued steroids after 7 infusions of tocilizumab. Secondary endpoints included disease activity and the number of relapses during 18-month follow-up. Results Thirteen patients with TAK were included, with a median age of 32 years [19–45] and 12 (92%) females. Six (54%) patients met the primary end-point. A significant decrease of disease activity was observed after 6 months of tocilizumab therapy: decrease of median NIH scale (3 [3, 4] at baseline, versus 1 [0–2] after 6 months; p < 0.001), ITAS-2010 score (5 [2–7] versus 3 [0–8]; p = 0.002), and ITAS-A score (7 [4–10] versus 4 [1–15]; p = 0.0001)]. During the 12-month follow-up after tocilizumab discontinuation, a relapse occurred among 5 patients (45%) out of 11 in which achieved remission after 6 months of tocilizumab. Conclusion Tocilizumab seems an effective steroid sparing therapy in TAK, but maintenance therapy is necessary. Trial registration ClinicalTrials.gov NCT02101333. Registered on 02 April 2014.

Download Full-text

Profiles of serum cytokine levels in Takayasu arteritis patients: Potential utility as biomarkers for monitoring disease activity

Journal of Cardiology ◽

10.1016/j.jjcc.2016.10.016 ◽

2017 ◽

Vol 70 (3) ◽

pp. 278-285 ◽

Cited By ~ 21

Author(s):

Natsuko Tamura ◽

Yasuhiro Maejima ◽

Daisuke Tezuka ◽

Chisato Takamura ◽

Shunji Yoshikawa ◽

...

Keyword(s):

Disease Activity ◽

Takayasu Arteritis ◽

Potential Utility ◽

Serum Cytokine ◽

Cytokine Levels

Download Full-text

Assessment of Disease Activity in Takayasu Arteritis: Potential Role of Contrast-Enhanced Ultrasound

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-0817-5423 ◽

2019 ◽

Vol 40 (05) ◽

pp. 638-645 ◽

Cited By ~ 3

Author(s):

Christian Lottspeich ◽

Claudia Dechant ◽

Anton Köhler ◽

Maximilian Tischler ◽

Karla Maria Treitl ◽

...

Keyword(s):

High Resolution ◽

Disease Activity ◽

Takayasu Arteritis ◽

Clinical Symptoms ◽

Inactive Disease ◽

Contrast Enhanced Ultrasound ◽

Acute Phase Reactants ◽

Contrast Enhanced ◽

Assessment Of Disease Activity ◽

Active Disease

Abstract Purpose To assess the diagnostic value of intima media thickness measurements and contrast-enhanced ultrasound (CEUS) of the supraaortic arteries in the assessment of disease activity in Takayasu arteritis (TA). Materials and Methods Patients with TA and involvement of the carotid and/or subclavian/axillary arteries underwent CEUS imaging in addition to B-mode and color duplex ultrasound. The maximum IMT (mIMT) was measured and high-resolution CEUS of the most prominently thickened vessel segment was performed. Two blinded readers reviewed the CEUS movies, with semiquantitative assessment of microbubble enhancement of the arterial wall (grade 0: no or minimal; grade 1: moderate; grade 2: pronounced). Clinical symptoms, acute phase reactants, and established indices of clinical disease activity (NIH criteria, ITAS score) were recorded. Results 40 examinations in 17 patients were analyzed. According to clinical judgement, 27 and 13 cases were classified as clinically inactive and active, respectively. An mIMT-cutoff of > 2.7 mm identified active disease with a sensitivity and specificity of 69.2 % and 88.9 %, respectively (area under the curve 0.83). The interobserver agreement of CEUS analysis was substantial (Cohen’s kappa 0.76). By consensus reading, 17, 15, and 8 cases were classified as uptake grade 0, grade 1 and grade 2, respectively. Grade 0 uptake was exclusively present in 17 clinically inactive patients. Grade 1 uptake was seen in 10 patients with clinically inactive disease and 5 patients with clinically active disease. Grade 2 uptake was exclusively present in 8 patients with active disease. Conclusion Both sonographic IMT measurements and high-resolution CEUS are promising in the ad-hoc assessment of disease activity in patients with TA.

Download Full-text