Difficult-to-treat Takayasu arteritis: a case-based review.

Biological therapy Janus kinase inhibitors Management Takayasu arteritis Tocilizumab Tumor necrosis factor inhibitors

Journal

Rheumatology international
ISSN: 1437-160X
Titre abrégé: Rheumatol Int
Pays: Germany
ID NLM: 8206885

Informations de publication

Date de publication:
23 Oct 2024
Historique:
received: 02 07 2024
accepted: 14 10 2024
medline: 23 10 2024
pubmed: 23 10 2024
entrez: 23 10 2024
Statut: aheadofprint

Résumé

Takayasu arteritis is a rare chronic inflammatory large vessel vasculitis which affects the aorta and its large branches. The diagnosis is based on the 2022 ACR/EULAR classification criteria for Takayasu arteritis. The management of this vasculitis is challenging. Although it is corticosteroid-responsive, relapses and disease progression are common. Thus, it is possible to resort to alternative conventional synthetic disease-modifying anti-rheumatic drugs and biologics, as second-line such as tumor necrosis factor-alpha inhibitors, tocilizumab, or JAK inhibitors as second-line agents is possible. Nevertheless, in some complex cases, the vasculitis remains active despite different proposed therapeutic lines, and a multitarget approach could induce sustained remission. We report herewith a case of 33-female patient with a refractory Takayasu arteritis which remained active after three different therapeutic lines with tocilizumab, then infliximab, then Upadacitinib. Finally, we consider a successful multitarget approach with a combination of infliximab, Upadacitinib, and methotrexate.

Identifiants

pubmed: 39441396
doi: 10.1007/s00296-024-05741-y
pii: 10.1007/s00296-024-05741-y
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Nabil Belfeki (N)

Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Sud Ile de France, Melun, France. nabil.belfeki@ghsif.fr.

Nouha Ghriss (N)

Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Sud Ile de France, Melun, France.

Renaud Guedec-Ghelfi (R)

EVESIO Department of Nuclear Medicine, Melun, France.

Sonia Kammoun (S)

Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Sud Ile de France, Melun, France.

Noemie Abisror (N)

Department of Internal Medicine, Inflammation-Immunopathology-Biotherapy, Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Antoine Paris, Paris, France.

Arsene Mekinian (A)

Department of Internal Medicine, Inflammation-Immunopathology-Biotherapy, Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Antoine Paris, Paris, France.
Sorbonne University, UMPC University Paris 06, INSERM U938, Centre de Recherche Saint-Antoine (CRSA), Paris, France.

Classifications MeSH