Effectiveness and safety of infliximab dose escalation in patients with refractory Takayasu arteritis: A real-life experience from a monocentric cohort
| العنوان: | Effectiveness and safety of infliximab dose escalation in patients with refractory Takayasu arteritis: A real-life experience from a monocentric cohort |
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| المؤلفون: | Alessandro Tomelleri, Corrado Campochiaro, Silvia Sartorelli, Francesco Baldassi, Federico Fallanca, Maria Picchio, Elena Baldissera, Lorenzo Dagna |
| المصدر: | Modern Rheumatology. 32:406-412 |
| بيانات النشر: | Oxford University Press (OUP), 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Cohort Studies, Treatment Outcome, Rheumatology, Humans, Psoriasis, Takayasu Arteritis, Infliximab, Retrospective Studies |
| الوصف: | Objectives To evaluate effectiveness and safety of infliximab dose escalation in Takayasu arteritis (TAK) patients. To identify factors associated with refractoriness to standard-dose infliximab. Methods Medical records of infliximab-treated TAK patients from a large single-centre observational cohort were reviewed. Infliximab therapy duration, concomitant therapies, and reasons for dose escalation and therapy suspension were evaluated. Occurrence of adverse events was recorded. A comparison between patients who maintained infliximab standard-dose and those who needed dose-escalation was performed. Factors associated with refractoriness to standard dose were analysed. Results Forty-one patients were included. Starting infliximab dose was 5 mg/kg 6-weekly and 28 patients (68%) needed dose escalation. Persistence/recurrence of clinical symptoms was the most frequent reason for escalation. Median therapy duration was 39 (IQR, 26–61) months in the standard-dose group and 68 (38–87) months in the intensified-dose group. In the intensified-dose-group, infliximab was suspended in eight patients (29%) after a median of 38 (31–71) months, due to loss of response (n = 7) or patient’s request (n = 1). Patients in the intensified-dose group had a higher number of relapses (3.4 vs 0.8 events/patient) and received a higher cumulative steroid dose (1.7 [1.6–2.3] vs 1.3 [1–1.6] g/month of prednisone). Three patients from the intensified-dose group had serious infections; one patient from the standard-dose group developed paradoxical psoriasis. At univariate analysis, age at diagnosis and age at infliximab start were associated with infliximab escalation. Conclusion In TAK, dose escalation is safe and allows to optimise infliximab durability in refractory patients. Younger patients seem to be more refractory to standard dosages. |
| تدمد: | 1439-7609 1439-7595 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2eaa3e4f2f4b66e3721d290826938396Test https://doi.org/10.1093/mr/roab012Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....2eaa3e4f2f4b66e3721d290826938396 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14397609 14397595 |
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