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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Tocilizumab for Treating Takayasu's Arteritis and Associated Stroke: A Case Series and Updated Review of the Literature
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Tocilizumab for Treating Takayasu's Arteritis and Associated Stroke: A Case Series and Updated Review of the Literature

机译：托库珠单抗治疗高津市的动脉炎和中风：一个病例系列和文献更新

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Background: Takayasu's arteritis (TA) is a rare inflammatory disease that can result in stroke. Treatment of patients with TA requires prolonged use of corticosteroids (CS). We assessed the effectiveness of tocilizumab (TCZ) in inducing disease remission and reducing CS doses in patients with TA. Methods: We retrospectively reviewed all patients with TA treated with TCZ and determined their response to therapy and adverse effects. We also summarized all reported TA patients treated with TCZ in the literature (both PubMed and MEDLINE) with no date or language restrictions and determined the utility of TCZ in inducing remission, acting as a CS sparing agent, and its adverse effects. Results: TCZ induced remission and reduction of CS doses in all 3 cases of TA in our cohort. Remission was achieved in 2 patients where stroke was the initial manifestation of active TA. In total, 3 of 4 patients with TA and stroke (2 from our study and 2 from other studies) treated with TCZ achieved remission and stability of their disease. We also identified 30 patients with TA treated with TCZ in the literature, of which 76.7% achieved remission despite the lack of sustained remission with other biological agents. In addition, TCZ resulted in a statistically significant reduction of CS in patients on CS before using TCZ (median, -8.8 mg/day; interquartile range, -19.4, to -3.4 mg/day; Wilcoxon P value,.0002). Conclusions: TCZ is a promising alternative for treating TA refractory to other biologics and for TA patients with stroke.
机译：背景：高津市的动脉炎（TA）是一种罕见的炎症性疾病，可导致中风。 TA患者的治疗需要长期使用皮质类固醇（CS）。我们评估了托珠单抗（TCZ）诱导TA患者疾病缓解和降低CS剂量的有效性。方法：我们回顾性研究了所有接受TCZ治疗的TA患者，并确定了他们对治疗的反应和不良反应。我们还总结了无日期或语言限制的文献（PubMed和MEDLINE）中所有报道的接受TCZ治疗的TA患者（无日期或语言限制），并确定了TCZ在诱导缓解，用作CS节约剂和其不良反应方面的效用。结果：在我们队列中的所有3例TA中，TCZ诱导了缓解并降低了CS剂量。卒中是活动性TA的最初表现的2名患者实现了缓解。总计，用TCZ治疗的4例TA和中风患者中有3例（本研究中2例，其他研究中2例）实现了疾病的缓解和稳定。在文献中，我们还确定了30例接受TCZ治疗的TA患者，尽管缺乏其他生物制剂的持续缓解，但仍有76.7％的患者获得了缓解。此外，在使用TCZ之前，TCZ可使CS患者的CS发生统计显着降低（中位数为-8.8 mg /天;四分位间距为-19.4至-3.4 mg /天; Wilcoxon P值为.0002）。结论：TCZ是治疗其他生物制剂难治性TA和卒中TA患者的有前途的替代方法。

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