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Rheumatology (Oxford). 2012 May;51(5):882-6. doi: 10.1093/rheumatology/ker380. Epub 2012 Jan 5.

Efficacy and tolerance of infliximab in refractory Takayasu arteritis: French multicentre study.

Author information

1
Service de Médecine Interne, Université Paris 13, AP-HP, Hôpital Jean Verdier, Bondy 93140, France. arsene.mekinian@jvr.aphp.fr

Abstract

OBJECTIVE:

To analyse the efficacy and tolerance of infliximab in refractory Takayasu arteritis (TA).

METHODS:

French multicentre retrospective study that included patients with TA. Clinical disease activity was defined as new vascular and/or constitutional signs.

RESULTS:

Fifteen patients with TA [median age 41 (range 17-61) years; 13 women] were included. At initiation of infliximab therapy, 14 patients were treated with CSs [prednisone; median dose 20 (range 5-35) mg/day], MTX (n = 7) or AZA (n = 4). Infliximab was used at median 5 (range 3-5) mg/kg at a median of every 6 (range 4-8) weeks. A partial or good overall response was noted in 13 (87%) of the 15 cases, 10 (77%) of the 13 cases and 8 (73%) of the 11 cases at 3, 6 and 12 months, respectively. Clinical and biological activities significantly decreased within 3 months (from 11 at baseline to 4 patients at 12 months; P < 0.05), and similarly for CS dose [from median 20 (range 5-35) mg/day at baseline to median 6 (range 2.5-30) mg/day at 12 months; P < 0.05]. Only one patient was still steroid-dependent at 12 months (vs 8 cases before infliximab). CRP regressed from a median 30 (range 4-70) mg/l to 5 (range 0-57) mg/l and 6 (0-50) mg/l at 3 and 6 months, respectively (P < 0.05). Side effects were two infusion-related reactions, one pulmonary tuberculosis, one severe bacterial infection and EBV reactivation.

CONCLUSION:

This study confirms the interest of infliximab in terms of clinical and biological response, as well as the steroid-sparing effect in TA.

PMID:
22223706
DOI:
10.1093/rheumatology/ker380
[Indexed for MEDLINE]

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