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)
ObjectivesThe feasibility of corticosteroid withdrawal (CW) for Takayasu arteritis (TAK) remains uncertain. Two autoantibodies (Abs) are identified against endothelial protein C receptor (EPCR) and scavenger receptor class B type 1 (SR-BI) in TAK, determining its three subgroups. This study aimed to...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1473100/full |
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| author | Tsuyoshi Shirai Tomonori Ishii Tomonori Ishii Soshi Okazaki Yuko Shirota Yusho Ishii Hiroko Sato Hiroshi Fujii |
| author_facet | Tsuyoshi Shirai Tomonori Ishii Tomonori Ishii Soshi Okazaki Yuko Shirota Yusho Ishii Hiroko Sato Hiroshi Fujii |
| author_sort | Tsuyoshi Shirai |
| collection | DOAJ |
| description | ObjectivesThe feasibility of corticosteroid withdrawal (CW) for Takayasu arteritis (TAK) remains uncertain. Two autoantibodies (Abs) are identified against endothelial protein C receptor (EPCR) and scavenger receptor class B type 1 (SR-BI) in TAK, determining its three subgroups. This study aimed to evaluate CW using tocilizumab (TCZ) and its association with the Ab profile.MethodsThis prospective study, lasted for 24 weeks, included patients with relapsed but stable TAK. Scheduled tapering of prednisolone (PSL) was performed with subcutaneous TCZ (CW at week 20). The primary endpoint was the difference in type A remission, defined by CW and the absence of inflammatory signs, according to the Ab profile at week 24.ResultsTwenty patients were included and 18 patients with a mean PSL dose of 4.9 ± 2.8 mg/day were analysed. Anti-EPCR Ab-positive (E+), anti-SR-BI Ab-positive (S+), and double-negative (DN) groups included four (22.2%), eight (44.4%), and six (33.3%) patients, respectively. At week 24, the mean PSL dose was 2.0 ± 2.7 mg/day. Type A remission was observed in eight patients (44.4%), with significant differences based on the Ab profile: E+ (three patients, 75%), S+ (five patients, 62.5%), and DN (zero patients, 0%) (P=0.018). Besides, age, disease duration, PSL dose, type V arterial lesion, arterial dilation, and C-reactive protein >0.01 mg/dL were identified as risks for CW failure.ConclusionCW using TCZ was achieved in 44.4% of patients with TAK relapse and was significantly higher in E+ and S+ patients. CW can be a feasible target, and the precise selection of patients is critical. |
| format | Article |
| id | doaj-art-007653f08b9d4d828993d8c0843181f5 |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-007653f08b9d4d828993d8c0843181f52025-01-07T06:51:41ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011510.3389/fimmu.2024.14731001473100Active 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)Tsuyoshi Shirai0Tomonori Ishii1Tomonori Ishii2Soshi Okazaki3Yuko Shirota4Yusho Ishii5Hiroko Sato6Hiroshi Fujii7Department of Clinical Rheumatology, Tohoku University Graduate School of Medicine, Sendai, JapanDepartment of Clinical Rheumatology, Tohoku University Graduate School of Medicine, Sendai, JapanDepartment of Hematology and Rheumatology, Tohoku Medical and Pharmaceutical University, Sendai, JapanDepartment of Clinical Rheumatology, Tohoku University Graduate School of Medicine, Sendai, JapanDepartment of Hematology and Rheumatology, Tohoku Medical and Pharmaceutical University, Sendai, JapanDepartment of Clinical Rheumatology, Tohoku University Graduate School of Medicine, Sendai, JapanDepartment of Clinical Rheumatology, Tohoku University Graduate School of Medicine, Sendai, JapanDepartment of Clinical Rheumatology, Tohoku University Graduate School of Medicine, Sendai, JapanObjectivesThe feasibility of corticosteroid withdrawal (CW) for Takayasu arteritis (TAK) remains uncertain. Two autoantibodies (Abs) are identified against endothelial protein C receptor (EPCR) and scavenger receptor class B type 1 (SR-BI) in TAK, determining its three subgroups. This study aimed to evaluate CW using tocilizumab (TCZ) and its association with the Ab profile.MethodsThis prospective study, lasted for 24 weeks, included patients with relapsed but stable TAK. Scheduled tapering of prednisolone (PSL) was performed with subcutaneous TCZ (CW at week 20). The primary endpoint was the difference in type A remission, defined by CW and the absence of inflammatory signs, according to the Ab profile at week 24.ResultsTwenty patients were included and 18 patients with a mean PSL dose of 4.9 ± 2.8 mg/day were analysed. Anti-EPCR Ab-positive (E+), anti-SR-BI Ab-positive (S+), and double-negative (DN) groups included four (22.2%), eight (44.4%), and six (33.3%) patients, respectively. At week 24, the mean PSL dose was 2.0 ± 2.7 mg/day. Type A remission was observed in eight patients (44.4%), with significant differences based on the Ab profile: E+ (three patients, 75%), S+ (five patients, 62.5%), and DN (zero patients, 0%) (P=0.018). Besides, age, disease duration, PSL dose, type V arterial lesion, arterial dilation, and C-reactive protein >0.01 mg/dL were identified as risks for CW failure.ConclusionCW using TCZ was achieved in 44.4% of patients with TAK relapse and was significantly higher in E+ and S+ patients. CW can be a feasible target, and the precise selection of patients is critical.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1473100/fullautoantibodycorticosteroidTakayasu arteritistocilizumabwithdrawal |
| spellingShingle | Tsuyoshi Shirai Tomonori Ishii Tomonori Ishii Soshi Okazaki Yuko Shirota Yusho Ishii Hiroko Sato Hiroshi Fujii 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) Frontiers in Immunology autoantibody corticosteroid Takayasu arteritis tocilizumab withdrawal |
| title | 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) |
| title_full | 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) |
| title_fullStr | 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) |
| title_full_unstemmed | 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) |
| title_short | 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) |
| title_sort | 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 |
| topic | autoantibody corticosteroid Takayasu arteritis tocilizumab withdrawal |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1473100/full |
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