Pathophysiology of large vessel vasculitis and utility of interleukin-6 inhibition therapy

Takayasu arteritis (TAK) and giant cell arteritis (GCA) affect mainly large- and medium-sized arteries. In refractory cases, vascular remodeling progresses and leads to serious outcomes. Studies have demonstrated that cytokines such as interleukin (IL)-6 play crucial roles in the pathophysiology of TAK and GCA. Recently, randomized controlled trials on IL-6 inhibition therapy using tocilizumab (TCZ) were performed, and significant effects were exhibited. The purposes of conventional treatments have been to improve symptoms and decrease the levels of inflammatory markers. Arterial changes have been considered as damages. However, after TCZ came into practical use, establishment of treat to target is desired to prevent vascular remodeling. In contrast, a combination therapy of glucocorticoids (GCs) and TCZ notably increases the risk of infections. When TCZ is used, careful attention must be paid to possible infections, and dose of GC should be tapered as much as possible. Future tasks are to establish indication and dosage of TCZ, indication for discontinuation of TCZ due to remission, efficacy of TCZ monotherapy, and protocols of TCZ for pediatric cases.

Errataetall:

CommentIn: Mod Rheumatol. 2020 Jan;30(1):213-217. - PMID 30793628

Medienart:

E-Artikel

Erscheinungsjahr:

2019

Erschienen:

2019

Enthalten in:

Zur Gesamtaufnahme - volume:29

Enthalten in:

Modern rheumatology - 29(2019), 2 vom: 14. März, Seite 287-293

Sprache:

Englisch

Beteiligte Personen:

Yoshifuji, Hajime [VerfasserIn]

Links:

Volltext

Themen:

Antibodies, Monoclonal, Humanized
Giant cell arteritis
I031V2H011
IL-6
Interleukin-6
Journal Article
Pathology
Review
Takayasu arteritis
Tocilizumab

Anmerkungen:

Date Completed 07.05.2019

Date Revised 07.05.2019

published: Print-Electronic

CommentIn: Mod Rheumatol. 2020 Jan;30(1):213-217. - PMID 30793628

Citation Status MEDLINE

doi:

10.1080/14397595.2018.1546358

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM290595797