Refractory Takayasu Arteritis Successfully Treated with Rituximab: Case-based Review

Overview

Journal Rheumatol Int

Specialty Rheumatology

Date 2019 Aug 8

PMID 31388749

Citations 6

Authors

Tomoyuki Mutoh

Tomonori Ishii

Tsuyoshi Shirai

Kanae Akita

Yukiko Kamogawa

Yoko Fujita

Hiroko Sato

Yuko Shirota

Hiroshi Fujii

Hideo Harigae

Affiliations

Soon will be listed here.

Abstract

Takayasu arteritis (TAK) is a subtype of the large-vessel vasculitis, affecting the aorta and its major branches. Although T cell-mediated autoimmunity is mainly involved in vascular inflammation, in recent years, accumulating evidence suggests the important role of B cells in the pathogenesis and effectiveness of B-cell-targeted therapy with rituximab (RTX), a chimeric anti-CD20 monoclonal antibody in refractory TAK. Herein, we report for the first time a case involving a 34-year-old man with TAK who was refractory to four different biologic agents, such as one selective T-cell co-stimulation modulator (abatacept), one anti-interleukin-6 receptor monoclonal antibody (tocilizumab), and two tumor necrosis factor-α inhibitors (infliximab and etanercept), but eventually achieved remission with RTX. He received a total of six courses of RTX, and doses of prednisolone and methotrexate were tapered without relapse. The current case provided further evidence to the potential role of RTX therapy in patients with refractory TAK, and its efficacy needs to be validated in a controlled trial.

Citing Articles

Active withdrawal of corticosteroids using tocilizumab and its association with autoantibody profiles in relapsed Takayasu arteritis: a multicentre, single-arm, prospective study (the Ab-TAK study).

Shirai T, Ishii T, Okazaki S, Shirota Y, Ishii Y, Sato H Front Immunol. 2025; 15():1473100.

PMID: 39840060 PMC: 11747699. DOI: 10.3389/fimmu.2024.1473100.

A Glimpse into Humoral Response and Related Therapeutic Approaches of Takayasu's Arteritis.

Guo S, Tian Y, Li J, Zeng X Int J Mol Sci. 2024; 25(12).

PMID: 38928233 PMC: 11203527. DOI: 10.3390/ijms25126528.

Common Autoantibody among Takayasu Arteritis and Ulcerative Colitis: A Possible Pathophysiology That Includes Gut-Vessel Connection in Vascular Inflammation.

Shirai T JMA J. 2023; 6(3):265-273.

PMID: 37560375 PMC: 10407456. DOI: 10.31662/jmaj.2023-0038.

Novel Therapies in Takayasu Arteritis.

Regola F, Uzzo M, Toniati P, Trezzi B, Sinico R, Franceschini F Front Med (Lausanne). 2022; 8:814075.

PMID: 35096902 PMC: 8790042. DOI: 10.3389/fmed.2021.814075.

Pathogenesis of liver injury in Takayasu arteritis: advanced understanding leads to new horizons.

Kang K, Sun Y, Li Y, Chang B J Int Med Res. 2020; 48(12):300060520972222.

PMID: 33275473 PMC: 7720339. DOI: 10.1177/0300060520972222.

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