Successful treatment with tocilizumab monotherapy for Takayasu arteritis developing during infliximab therapy in a patient with ulcerative colitis

Shibata, Akiko; Kurasawa, Takahiko; Okada, Yusuke; Chino, Kentaro; Saito, Shuntaro; Okuyama, Atsushi; Takei, Hiroyuki; Sakai, Ryota; Kondo, Tsuneo; Amano, Koichi

doi:10.1080/24725625.2018.1479155

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…Our cases suggest that TCZ has the potential to cause adverse effects on the intestinal mucosa, and it is therefore considered to be a risk factor for UC with TCZ therapy. Certainly, some cases in which TCZ treatment improved UC, as opposed to our cases and those discussed above, have been reported (25)(26)(27)(28). The contradictory results seem to be due to the balance between the disadvantages of inhibiting classic-signaling and the benefits of blocking transsignaling.…”

Section: Discussioncontrasting

confidence: 68%

Exacerbation of Ulcerative Colitis with Tocilizumab: A Report of Two Cases, One with Takayasu Arteritis and the Other with Relapsing Polychondritis

et al. 2021

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Tocilizumab (TCZ), a biologic that blocks the signal transduction of interleukin-6, has been used for the treatment of various autoimmune diseases. Many of these cases are sometimes complicated by ulcerative colitis (UC). However, the effect of TCZ on UC is unclear. We experienced two cases with concomitant UC that were treated with TCZ, one for Takayasu arteritis (TAK) and the other for relapsing polychondritis (RP). TCZ did not improve UC in either of these cases. TCZ might have adverse effects on the intestinal tract, since interleukin-6 signaling plays an important role in intestinal epithelium maintenance. Treatment with TCZ should therefore be carefully provided in patients complicated with UC.

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Section: Discussioncontrasting

confidence: 68%

Exacerbation of Ulcerative Colitis with Tocilizumab: A Report of Two Cases, One with Takayasu Arteritis and the Other with Relapsing Polychondritis

et al. 2021

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“…Future research is required on whether initial combination or add-on of TCZ is more reasonable. Successful monotherapy with TCZ has been reported in TAK [51] and GCA [49,52], although validation is needed. Combination of TCZ and immunosuppressive drugs might be an option.…”

Section: Indication Efficacy and Safety Of Il-6 Inhibitionmentioning

confidence: 99%

Pathophysiology of large vessel vasculitis and utility of interleukin-6 inhibition therapy

Yoshifuji

2019

Modern Rheumatology

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Takayasu arteritis (TAK) and giant cell arteritis (GCA) affect mainly large-and medium-sized arteries. In refractory cases, vascular remodeling progresses and leads to serious outcomes. Studies have demonstrated that cytokines such as interleukin (IL)-6 play crucial roles in the pathophysiology of TAK and GCA. Recently, randomized controlled trials on IL-6 inhibition therapy using tocilizumab (TCZ) were performed, and significant effects were exhibited. The purposes of conventional treatments have been to improve symptoms and decrease the levels of inflammatory markers. Arterial changes have been considered as damages. However, after TCZ came into practical use, establishment of treat to target is desired to prevent vascular remodeling. In contrast, a combination therapy of glucocorticoids (GCs) and TCZ notably increases the risk of infections. When TCZ is used, careful attention must be paid to possible infections, and dose of GC should be tapered as much as possible. Future tasks are to establish indication and dosage of TCZ, indication for discontinuation of TCZ due to remission, efficacy of TCZ monotherapy, and protocols of TCZ for pediatric cases.

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Infliximab

2018

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Successful treatment with tocilizumab monotherapy for Takayasu arteritis developing during infliximab therapy in a patient with ulcerative colitis

Cited by 4 publications

References 19 publications

Exacerbation of Ulcerative Colitis with Tocilizumab: A Report of Two Cases, One with Takayasu Arteritis and the Other with Relapsing Polychondritis

Exacerbation of Ulcerative Colitis with Tocilizumab: A Report of Two Cases, One with Takayasu Arteritis and the Other with Relapsing Polychondritis

Pathophysiology of large vessel vasculitis and utility of interleukin-6 inhibition therapy

Infliximab

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