Refractory Takayasu arteritis successfully treated with rituximab: case-based review

Rheumatology International
Tomoyuki MutohHideo Harigae

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.

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Citations

Mar 20, 2020·Internal Medicine·Tsuyoshi ShiraiHideo Harigae
May 21, 2020·Zeitschrift für Rheumatologie·B Hellmich
Oct 13, 2020·Current Rheumatology Reports·B HellmichR Luqmani
Dec 5, 2020·The Journal of International Medical Research·Kai KangBing Chang
Mar 18, 2021·Scandinavian Journal of Rheumatology·T ShiraiH Harigae

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