Dramatic Response to Tocilizumab Before Emergency Surgery in Severe Active Takayasu Disease

Risse, Jacques; Mandry, Damien; Settembre, Nicla; Vigouroux, C.; Claudin, Marine; Tsintzila, Georgia; Huttin, Olivier; Malikov, Sergueï; Zuily, Stéphane; Wahl, Denis

doi:10.1161/circimaging.116.004819

Cited by 9 publications

(2 citation statements)

References 4 publications

(6 reference statements)

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“…[ 93 ] For patients who underwent emergency/confine surgery during active phase due to critical conditions, highdose GC should be considered, [ 5 ] or GC combined with csD-MARDs or bDMARDs (such as tocilizumab or TNF inhibitors) in order to achieve remission rapidly. [ 105 ] Although perioperative immunosuppressive therapy has adverse reactions, they are generally controllable.…”

Section: Recommendationsmentioning

confidence: 99%

Chinese guideline for the diagnosis and treatment of Takayasu’s arteritis (2023)

Tian,

Zeng

2024

Rheumatology and Immunology Research

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Takayasu’s arteritis (TAK) is a chronic granulomatous inflammatory disease that involves aorta and its primary branches. It is characterized by wall thickening, stenosis/obliteration or aneurysm formation of the involved arteries. In order to standardize the diagnosis and treatment of TAK in China, a clinical practice guideline with an evidence-based approach is developed under the leadership of National Clinical Medical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID). Eleven recommendations for 11 clinical questions that are important to the diagnosis and treatment of TAK are developed based on the latest evidence and expert opinions combined with real clinical practice in China.

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Section: Recommendationsmentioning

confidence: 99%

Chinese guideline for the diagnosis and treatment of Takayasu’s arteritis (2023)

Tian,

Zeng

2024

Rheumatology and Immunology Research

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“…We also recommend 100-200 mg intravenous hydrocortisone pre-and post-procedure for all patients. In the face of active arteritis and the need for emergency surgery we have used intravenous biologic therapy with anti-IL-6 receptor or anti-TNFα monoclonal antibodies in the pre-operative period to reduce the inflammatory burden, an approach recently reported by others (36).…”

Section: Pre-surgery Assessment and Peri-operative Medical Therapymentioning

confidence: 99%

Surgical intervention and its role in Takayasu arteritis

Mason

2018

Best Practice & Research Clinical Rheumatology

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Vascular surgery remains an important option in the management of Takayasu arteritis. Its use is predominantly confined the treatment of symptomatic organ ischaemia or life-threatening aneurysm formation. In most cases this follows the failure of medical therapy to prevent arterial injury. Open surgery and endovascular approaches are used. The choice between them, at least in part, is determined by the site and nature of the lesion. Although more invasive, open surgery offers enhanced duration of arterial patency. For endovascular intervention, primary angioplasty without stenting is preferred, with stenting reserved for primary or secondary angioplasty failures. Although there is increasing interest in the role of stent grafts and tailor-made endovascular stents, long-term outcomes remain to be reported. Interventional outcomes are improved and complications reduced by therapeutic control of disease activity pre-and post-surgery. The wider use of combined immunosuppression and the introduction of biologic therapy for refractory Takayasu arteritis may reduce future requirements for surgical intervention.

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Treatment

Alıbaz-Öner¹,

Direşkeneli²

2021

Rare Diseases of the Immune System

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Dramatic Response to Tocilizumab Before Emergency Surgery in Severe Active Takayasu Disease

Cited by 9 publications

References 4 publications

Chinese guideline for the diagnosis and treatment of Takayasu’s arteritis (2023)

Chinese guideline for the diagnosis and treatment of Takayasu’s arteritis (2023)

Surgical intervention and its role in Takayasu arteritis

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