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


CONCLUSIONS
This study confirms the interest of infliximab in terms of clinical and biological response, as well as the steroid-sparing effect in TA.
Service de Médecine Interne, Université Paris 13, AP-HP, Hôpital Jean Verdier, Bondy 93140, France. arsene.mekinian@jvr.aphp.fr
Arsène
A
Mekinian
Antoine
A
Néel
Jean
J
Sibilia
Pascal
P
Cohen
Jérome
J
Connault
Marc
M
Lambert
Laure
L
Federici
Sabine
S
Berthier
Jean-Noel
JN
Fiessinger
Bertrand
B
Godeau
Isabelle
I
Marie
Loïc
L
Guillevin
Mohamed
M
Hamidou
Olivier
O
Fain
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013625:Takayasu Arteritis / Q000188:drug therapy*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab