Michio Otsuki    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor and Division head
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Tocilizumab for the treatment of patients with refractory Takayasu arteritis.
Journal	Formal name：International Heart Journal Abbreviation：Int Heart J ISSN code：13492365
Domestic / Foregin	Foregin
Volume, Issue, Page	54(6),pp.405-411
Author and coauthor	Nakaoka Yoshikazu, Higuchi Kaori, Arita Yoh, Otsuki Michio, Yamamoto Kaori, Hashimoto-Kataoka Takahiro, Yasui Taku, Ikeoka Kuniyasu, Ohtani Tomohito, Sakata Yasushi, Shima Yoshihito, Kumanogoh Atsushi, Yamauchi-Takihara Keiko, Tanaka Toshio, Kishimoto Tadamitsu, Komuro Issei
Publication date	2013
Summary	Treatment of refractory Takayasu arteritis (TA) remains an unresolved clinical issue. Patients usually respond to glucocorticoid (GC) therapy, but often relapse on tapering of the GC dose. The aim of the present study was to assess the safety and efficacy of the interleukin-6 (IL-6) receptor antibody tocilizumab (TCZ) in patients with TA refractory to conventional therapies including GC. Four patients with TA who had shown GC resistance received TCZ infusions (8 mg/kg) every 4 weeks a total of at least 24 times (range, 24 to 51). Clinical symptoms, the serum levels of acute phase proteins and IL-6, GC dosage necessary to maintain remission, and cross-sectional imaging by enhanced CT and MRI were assessed. All patients achieved good clinical response and rapid normalization of the acute phase proteins such as C-reactive protein and serum amyloid A during the therapy with TCZ. The mean dosage of prednisolone could be reduced from 21.3 mg/day to 1.5 mg/day. Although the serum IL-6 level was transiently elevated in all patients after several TCZ infusions, it gradually recovered to the initial level. Along with the decrease of serum IL-6, two patients exhibited significant reduction in thickened arterial lesions. No drug-related adverse effects were noted. In this small group of patients with refractory TA, TCZ therapy was effective and well-tolerated. Further larger studies should be conducted to confirm this finding.
DOI	10.1536/ihj.54.405
PMID	24309452