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Multicenter Study
. 2023 Jun;9(2):e002830.
doi: 10.1136/rmdopen-2022-002830.

Intravenous versus subcutaneous tocilizumab in Takayasu arteritis: multicentre retrospective study

Arsène Mekinian  1 , Lucie Biard  2 , Dagna Lorenzo  3 , Pavel I Novikov  4 , Carlo Salvarani  5 , Olivier Espitia  6 , Savino Sciascia  7 , Martin Michaud  8 , Marc Lambert  9 , José Hernández-Rodríguez  10 , Nicolas Schleinitz  11 , Abid Awisat  12 , Xavier Puechal  13 , Achille Aouba  14 , Helene Munoz Pons  15 , Ilya Smitienko  16 , Jean Baptiste Gaultier  17 , Le Mouel Edwige  18 , Ygal Benhamou  19 , Antoinette Perlat  18 , Patrick Jego  18 , Tiphaine Goulenok  20 , Karim Sacre  20 , Bertrand Lioger  21 , Nolan Hassold  22 , Jonathan Broner  23 , Virginie Dufrost  24 , Thomas Sené  25 , Julie Seguier  11 , Francois Maurier  26 , Sabine Berthier  27 , Alexandre Belot  28 , Faten Frikha  29 , Guillaume Denis  30 , Alexandra Audemard-Verger  31 , Isabelle Koné-Paut  22 , Sebastien Humbert  32 , Pascal Woaye-Hune  33 , Alessandro Tomelleri  3 , Elena Marina Baldissera  3 , Masataka Kuwana  34 , Alberto Lo Gullo  35 , Vahan Mukuchyan  36 , Azeddine Dellal  37 , Francis Gaches  8 , Pierre Zeminsky  24 , Elena Galli  3 , Moya Alvarado  5 , Luigi Boiardi  5 , Francesco Muratore  5 , Mathieu Vautier  2 , Corrado Campochiaro  3 , Sergey Moiseev  4 , Matheus Vieira  38 , Patrice Cacoub  38 , Olivier Fain  39 , David Saadoun  38 ; French Takayasu network
Affiliations
Multicenter Study

Intravenous versus subcutaneous tocilizumab in Takayasu arteritis: multicentre retrospective study

Arsène Mekinian et al. RMD Open. 2023 Jun.

Erratum in

Abstract

Objectives: In this large multicentre study, we compared the effectiveness and safety of tocilizumab intravenous versus subcutaneous (SC) in 109 Takayasu arteritis (TAK) patients.

Methods: We conducted a retrospective multicentre study in referral centres from France, Italy, Spain, Armenia, Israel, Japan, Tunisia and Russia regarding biological-targeted therapies in TAK, since January 2017 to September 2019.

Results: A total of 109 TAK patients received at least 3 months tocilizumab therapy and were included in this study. Among them, 91 and 18 patients received intravenous and SC tocilizumab, respectively. A complete response (NIH <2 with less than 7.5 mg/day of prednisone) at 6 months was evidenced in 69% of TAK patients, of whom 57 (70%) and 11 (69%) patients were on intravenous and SC tocilizumab, respectively (p=0.95). The factors associated with complete response to tocilizumab at 6 months in multivariate analysis, only age <30 years (OR 2.85, 95% CI 1.14 to 7.12; p=0.027) and time between TAK diagnosis and tocilizumab initiation (OR 1.18, 95% CI 1.02 to 1.36; p=0.034). During the median follow-up of 30.1 months (0.4; 105.8) and 10.8 (0.1; 46.4) (p<0.0001) in patients who received tocilizumab in intravenous and SC forms, respectively, the risk of relapse was significantly higher in TAK patients on SC tocilizumab (HR=2.55, 95% CI 1.08 to 6.02; p=0.033). The overall cumulative incidence of relapse at 12 months in TAK patients was at 13.7% (95% CI 7.6% to 21.5%), with 10.3% (95% CI 4.8% to 18.4%) for those on intravenous tocilizumab vs 30.9% (95% CI 10.5% to 54.2%) for patients receiving SC tocilizumab. Adverse events occurred in 14 (15%) patients on intravenous route and in 2 (11%) on SC tocilizumab.

Conclusion: In this study, we confirm that tocilizumab is effective in TAK, with complete remission being achieving by 70% of disease-modifying antirheumatic drugs-refractory TAK patients at 6 months.

Keywords: Autoimmune Diseases; Inflammation; Systemic vasculitis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) The cumulative incidence of relapse by route of administration. (B) HR of risk of relapse by route of administration. IV, intravenous; SC, subcutaneous. *=p<0.05.
Figure 2
Figure 2
The cumulative incidence of treatment doiscontinuation by route of administration. IV, intravenous; SC, subcutaneous.
See this image and copyright information in PMC

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