Service de médecine interne A, CHU de Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France.
Service de médecine interne, hôpital Jean-Verdier, Assistance Publique-hôpitaux de Paris, Bondy, France.
Joint Bone Spine. 2014 Jan;81(1):76-8. doi: 10.1016/j.jbspin.2013.06.004. Epub 2013 Jul 24.
Giant cell arteritis is a primary large-vessel vasculitis characterized by an arterial wall inflammation associated with intimal hyperplasia leading to arterial occlusion. Glucocorticoids remain the mainstay of giant cell arteritis treatment. However, relapses and glucocorticoid-related complications are frequent and therapeutic options for refractory giant cell arteritis are quite limited. Like tumor necrosis factor-α and interleukin-6, interleukin-1β is also highly expressed in inflamed arterial walls of patients with giant cell arteritis and may contribute in the pathogenesis of this disease. We report treatment of three cases of refractory giant cell arteritis successfully treated with anakinra, an interleukin-1 blockade therapy. Anakinra was effective for all patients, yielding improvement in their inflammation biomarkers and/or in their symptoms, as well as a disappearance of arterial inflammation in PET/CT for two of them.
巨细胞动脉炎是一种主要的大血管血管炎，其特征为动脉壁炎症伴有内膜增生，导致动脉闭塞。糖皮质激素仍然是巨细胞动脉炎治疗的主要方法。然而，复发和糖皮质激素相关的并发症很常见，而且对于难治性巨细胞动脉炎的治疗选择相当有限。与肿瘤坏死因子-α和白细胞介素-6一样，白细胞介素-1β在巨细胞动脉炎患者的炎症动脉壁中也高度表达，可能有助于该病的发病机制。我们报告了三例难治性巨细胞动脉炎患者成功接受白细胞介素-1阻滞剂阿那白滞素治疗的情况。阿那白滞素对所有患者均有效，改善了他们的炎症生物标志物和/或症状，其中两人的动脉炎症在 PET/CT 上消失。
