Akdeniz University Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Antalya, Turkey.
Clin Exp Rheumatol. 2021 Mar-Apr;39 Suppl 129(2):135-141. doi: 10.55563/clinexprheumatol/z6drbj. Epub 2021 Jan 15.
The aim of the present study was to evaluate the effects of biological disease-modifying antirheumatic drugs (bDMARDs) administered to patients with Takayasu's arteritis (TAK) on disease activity and vascular damage.
This study included TAK patients who were receiving bDMARDs for at least six months. Disease activity (National Institutes of Health [NIH]), vascular lesions, and vascular damage (Combined Arteritis Damage Score [CARDS]) scores were determined.
There were 21 TAK patients who received infliximab (INF) and/or tocilizumab (TCZ) (mean age = 38.6±11.8 years; female proportion = 20 [95.2%]). The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, and NIH disease activity score were found to significantly decrease with bDMARD treatments. There were also significant decreases in the mean CARDS and the total number of vascular lesions after treatment (p<0.05). Unlike occlusions, an important decrease was observed in the occurrences of stenosis and aneurysms with bDMARD treatments. Regression was detected in the vascular lesions of 15 (71.4%) patients compared to the last image before bDMARD therapies.
Our study results indicate that biological agents, such as INF and/or TCZ, that are used in the treatmentof TAK are capable of remedying certain vascular lesions and may provide additional benefits to patients with TAK who do not sufficiently respond to conventional synthetic disease-modifying antirheumatic drug (DMARD) treatment.
本研究旨在评估生物改善病情抗风湿药（bDMARDs）治疗 Takayasu 动脉炎（TAK）患者对疾病活动度和血管损伤的影响。
本研究纳入了至少接受 bDMARD 治疗 6 个月的 TAK 患者。评估疾病活动度（美国国立卫生研究院 [NIH]）、血管病变和血管损伤（联合动脉炎损伤评分 [CARDS]）评分。
共纳入 21 例接受英夫利昔单抗（INF）和/或托珠单抗（TCZ）治疗的 TAK 患者（平均年龄 38.6±11.8 岁；女性比例 20 [95.2%]）。bDMARD 治疗后，红细胞沉降率（ESR）、C 反应蛋白（CRP）水平和 NIH 疾病活动评分均显著降低。治疗后 CARDS 均值和血管病变总数也显著降低（p<0.05）。与闭塞不同，狭窄和动脉瘤的发生率在 bDMARD 治疗后显著下降。与 bDMARD 治疗前的最后一张图像相比，15 例（71.4%）患者的血管病变出现了消退。
我们的研究结果表明，INF 和/或 TCZ 等生物制剂可用于治疗 TAK，可纠正某些血管病变，并为未充分响应传统合成改善病情抗风湿药（DMARD）治疗的 TAK 患者带来额外获益。
