Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, Beijing, China.
RMD Open. 2023 Mar;9(1). doi: 10.1136/rmdopen-2023-003007.
To investigate the effectiveness and safety of TCZ (tocilizumab) monotherapy for chronic periaortitis (CP) patients at acute active stage.
Twelve patients with definite or possible diagnosis of CP were enrolled and received intravenous infusions of TCZ (8 mg/kg) every 4 weeks for at least 3 months. Clinical features, laboratory and imaging findings were recorded at baseline and during the follow-up. The primary endpoint was the rate of partial and complete remission after 3 months TCZ monotherapy and the secondary endpoint was the frequency of treatment related adverse events.
Three patients (27.3%) achieved partial remission and seven patients (63.6%) obtained complete remission after 3 months TCZ treatment. The total remission rate achieved 90.9%. All patients reported improvement in clinical symptoms. Inflammatory markers such as erythrocyte sedimentation rate and C reactive protein decreased to normal levels after TCZ treatment. Nine patients (81.8%) showed remarkable shrinkage of perivascular mass greater than or equal to 50% on CT.
Our study showed that TCZ monotherapy contributed to remarkable clinical and laboratory improvement in CP patients and could be an alternative treatment option for CP.
探讨 TCZ（托珠单抗）单药治疗处于急性活动期的慢性大动脉炎（CP）患者的有效性和安全性。
纳入 12 例明确或可能诊断为 CP 的患者，给予 TCZ（8mg/kg）静脉输注，每 4 周 1 次，至少治疗 3 个月。在基线和随访期间记录临床特征、实验室和影像学发现。主要终点为 TCZ 单药治疗 3 个月后的部分缓解和完全缓解率，次要终点为治疗相关不良事件的频率。
3 例（27.3%）患者在 TCZ 治疗 3 个月后获得部分缓解，7 例（63.6%）患者获得完全缓解。总缓解率达到 90.9%。所有患者的临床症状均有改善。红细胞沉降率和 C 反应蛋白等炎症标志物在 TCZ 治疗后降至正常水平。9 例（81.8%）患者 CT 显示血管周围肿块缩小≥50%。
本研究表明 TCZ 单药治疗可显著改善 CP 患者的临床和实验室指标，是 CP 的一种替代治疗选择。
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