The efficacy of tocilizumab for the treatment of Chinese Takayasu's arteritis.

OBJECTIVES: The aim of this study was to evaluate the efficacy and safety of tocilizumab (TCZ) in Chinese Takayasu's arteritis (TAK) patients.

METHODS: This was a single-centre prospective study. Sixteen consecutive TAK patients were included. Patients were treated with tocilizumab infusions with a dosage of 8 mg/kg. Serum inflammation markers including erythrocyte sedimentation rate (ESR) and hypersensitivity C-reactive protein (hsCRP) were recorded at baseline and before each TCZ infusion. Doppler ultrasonography was used to track vascular changes every 6 months during the study. The efficacy and safety profile of patients during the study were collected and analysed.

RESULTS: Sixteen patients with a median age of 26.5 (18-47) were recruited and analysed. One patient was treatment naïve; the others had taken a median of 3 (1-5) conventional immune suppressants before TCZ therapy. Three patients withdrew TCZ after 1 infusion due to unbearable neck pain. The other 13 patients were treated with TCZ for a median of 13 (7-20) months. After TCZ treatment, the median ESR, hsCRP level, mural thickness of common carotid artery and subclavical artery decreased from 39 (7-92) mm/h, 28.88 (7.6-155.93) mg/L, 0.24 (0.06-0.59) cm, 0.18 (0.07-0.47) cm to 6 (1-30) mm/h (p<0.001), 0.59 (0.08-19.12) mg/L (p=0.006), 0.17 (0.04-0.53) cm (p<0.001), and 0.12 (0.07-0.18) cm (p=0.035) respectively. The glucocorticosteroid dosage was tapered or maintained in all patients. One episode of urinary infection was recorded and relieved after antibiotic therapy. Neither neutropenia nor abnormal liver enzyme was observed.

CONCLUSIONS: Our study suggests that TCZ is a safe and effective agent for long-term treatment in Chinese TAK patients.