Tocilizumab improves outcomes in patients with Takayasu arteritis
A long-term course of once-weekly tocilizumab in patients with Takayasu arteritis appears to exert a steroid-sparing effect and yields improvements in well-being without raising new safety concerns, according to data from the Takayasu Arteritis Treated with Tocilizumab trial.
The present analysis included 36 patients who completed the double-blind treatment period and entered the open-label extension, among whom 28 received tocilizumab administered subcutaneously at 162 mg for 96 weeks. Oral glucocorticoid tapering was performed at the investigators' discretion.
Endpoints of the extension analysis included steroid-sparing effects of tocilizumab, imaging data, patient-reported outcomes (36-Item Short Form Health Survey) and safety.
The median dose of glucocorticoid was 0.223 mg/kg/day at the time of relapse before study entry, 0.131 mg/kg/day after 48 weeks, and 0.105 mg/kg/day after 96 weeks. At week 96, exposure in 46.4 percent of patients was lowered to <0.1 mg/kg/day—a dose that was less than half that administered at relapse before study entry (mean difference, –0.120 mg/kg/day). Seven patients had entirely discontinued glucocorticoids, and none of them experienced relapse.
Based on imaging data, disease improved in 17.9 percent of patients or remained stable in 67.9 percent after 96 weeks vs baseline. Mean physical and mental component summary scores, as well as seven of eight domain scores, on the 36-Item Short Form Health Survey improved from baseline, with the improvements maintained over 96 weeks of treatment. There were no unexpected safety issues observed.