Tocilizumab in refractory Takayasu arteritis: a case series and updated literature review

Autoimmun Rev. 2013 Oct;12(12):1143-9. doi: 10.1016/j.autrev.2013.06.019. Epub 2013 Jun 29.


Background/purpose: The aim of this study is to analyze the efficacy and tolerance of tocilizumab in patients with Takayasu arteritis (TA).

Methods: We retrospectively studied patients with TA (ACR and/or Ishikawa's criteria): 5 French multicenter cases and 39 from the literature. Clinical, biological, radiological disease activity and treatment were analyzed before tocilizumab, during the follow-up and at the last available visit.

Results: Forty-four patients (median age 26years [3-65];) were included in the present study: 5 patients from the 3 French university hospitals and 39 cases from the literature review. Median follow-up after initiation of tocilizumab was 15months [8-33]. Clinical and biological activities significantly decreased within 3months, similarly to steroid amount (from 15mg/day [5-75] at baseline to 10mg/day [2-30] at 6months; p<0.05) and steroid-dependence rate. Even radiological activity did not significantly decrease at 6months, significant decrease of arterial FDG uptake was noted at 6months. Median duration of tocilizumab treatment was 9months [3-180]. At the last visit, tocilizumab was continued in 17/32 patients (53%), and was discontinued in the 15 remaining cases because of the remission (n=5), relapse (n=3), persistent radiological activity (n=3), cutaneous rash (n=2), severe infection (n=1) and lacking of care welfare system (n=1). No death related to tocilizumab treatment was noted.

Conclusion: This study show the efficacy of tocilizumab in terms of clinical, biological and radiological response, as well as steroid-sparing agent. Only well-designed studies could definitely address the efficacy of tocilizumab in TA.

Keywords: Takayasu arteritis; Tocilizumab; Treatment.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Steroids / therapeutic use
  • Takayasu Arteritis / drug therapy*
  • Treatment Outcome
  • Young Adult


  • Antibodies, Monoclonal, Humanized
  • Immunosuppressive Agents
  • Steroids
  • tocilizumab