Refractory Takayasu arteritis successfully treated with rituximab: case-based review

Tomoyuki Mutoh, Tomonori Ishii, Tsuyoshi Shirai, Kanae Akita, Yukiko Kamogawa, Yoko Fujita, Hiroko Sato, Yuko Shirota, Hiroshi Fujii, Hideo Harigae

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Takayasu arteritis (TAK) is a subtype of the large-vessel vasculitis, affecting the aorta and its major branches. Although T cell-mediated autoimmunity is mainly involved in vascular inflammation, in recent years, accumulating evidence suggests the important role of B cells in the pathogenesis and effectiveness of B-cell-targeted therapy with rituximab (RTX), a chimeric anti-CD20 monoclonal antibody in refractory TAK. Herein, we report for the first time a case involving a 34-year-old man with TAK who was refractory to four different biologic agents, such as one selective T-cell co-stimulation modulator (abatacept), one anti-interleukin-6 receptor monoclonal antibody (tocilizumab), and two tumor necrosis factor-α inhibitors (infliximab and etanercept), but eventually achieved remission with RTX. He received a total of six courses of RTX, and doses of prednisolone and methotrexate were tapered without relapse. The current case provided further evidence to the potential role of RTX therapy in patients with refractory TAK, and its efficacy needs to be validated in a controlled trial.

Original languageEnglish
Pages (from-to)1989-1994
Number of pages6
JournalRheumatology International
Volume39
Issue number11
DOIs
Publication statusPublished - 2019 Nov 1

Keywords

  • B cells
  • Large-vessel vasculitis
  • Rituximab
  • Takayasu arteritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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