The effects of biological agents on vascular structural lesions in Takayasu’s arteritis

Abstract

Objective. The aim of the present study was to evaluate the effects of biological disease-modifying anti-rheumatic drugs (bDMARDs) administered to patients with Takayasu’s arteritis (TAK) on disease activity and vascular damage. Methods. This study included TAK patients who were receiving bDMARDs for at least six months. Disease activity (National Institutes of Health [NIH]), vascular lesions, and vascular damage (Combined Arteritis Damage Score [CARDS]) scores were determined. Results. There were 21 TAK patients who received infliximab (INF) and/ or tocilizumab (TCZ) (mean age = 38.6±11.8 years; female proportion = 20 [95.2%]). The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, and NIH disease activity score were found to significantly decrease with bDMARD treatments. There were also significant decreases in the mean CARDS and the total number of vascular lesions after treatment (p<0.05). Unlike occlusions, an important decrease was observed in the occurrences of stenosis and aneurysms with bDMARD treatments. Regression was detected in the vascular lesions of 15 (71.4%) patients compared to the last image before bDMARD therapies. Conclusion. Our study results indicate that biological agents, such as INF and/ or TCZ, that are used in the treatment of TAK are capable of remedying certain vascular lesions and may provide additional benefits to patients with TAK who do not sufficiently respond to conventional synthetic disease-modifying anti-rheumatic drug (DMARD) treatment.