Objective: To assess the efficacy and safety of tocilizumab and cyclophosphamide in patients with Takayasu arteritis (TA). Methods: Twenty-seven TA patients treated with tocilizumab (TCZ group) and 22 treated with cyclophosphamide (CTX group) were enrolled and retrospectively analyzed. The duration of treatment was 6 months. Disease activity and side effects were compared between the two groups. Results: After treatment, the median C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and disease activity scores in TCZ group were significantly lower than those in CTX group respectively [ESR 3 mm/1h vs. 8 mm/1h; CRP 0.13 mg/L vs. 1.09 mg/L; National Institutes of Health (NIH) score 0(0,1) vs. 0(1,1); the Indian Takayasu clinical activity score (ITAS 2010) 0(0,2) vs. 2(0,3.5), and the Indian Takayasu activity score with the acute phase response (ITAS-A) 0(0,2) vs. 2.5(0,3.5); all P<0.05]. The daily prednisone doses before treatment and after treatment in TCZ group were significantly lower than those in CTX group [(20.1±15.9) mg/d vs. (39.3±16.7) mg/d;(5.1±4.2)mg/d vs. (12.1±4.6) mg/d,both P<0.05)].The incidence of drug-related side effects in TCZ group was significantly lower than that in CTX group, which was 22.2% vs. 54.5% (P<0.05). Conclusion: Compared with CTX treatment, TCZ treatment for TA with less prednisone has better efficacy and safety.
目的： 探讨托珠单抗治疗大动脉炎患者的有效性和安全性。 方法： 纳入2015年1月至2018年6月首都医科大学附属北京安贞医院风湿免疫科住院且未经治疗的大动脉炎患者，27例应用托珠单抗联合激素治疗（托珠单抗组），22例应用环磷酰胺联合激素治疗（环磷酰胺组），连续应用6个月，比较治疗前后美国国立卫生研究院大动脉炎评分（简称NIH评分）、印度北方医学科学研究所2010年印度大动脉炎活动度评分（简称ITAS2010评分）、印度北方医学科学研究所印度大动脉炎活动度-A评分（简称ITAS-A评分）、红细胞沉降率、C反应蛋白等及泼尼松用量和药物副作用。 结果： 托珠单抗组治疗后红细胞沉降率[3（2，6）mm/1h比8（5，17）mm/1h]、C反应蛋白[0.13（0.05，0.99）mg/L比1.09（0.46，3.33）mg/L]、NIH评分[0（0，1）比0（1，1）]、ITAS2010评分[0（0，2）比2（0，3.5）]、ITAS-A评分[0（0，2）比2.5（0，3.5）]较环磷酰胺组明显下降，差异均有统计学意义（P值均<0.05）。泼尼松用量托珠单抗组显著少于环磷酰胺组[治疗前：（20.1±15.9）mg/d比（39.3±16.7）mg/d，P<0.05；治疗后：（5.1±4.2）mg/d比（12.1±4.6）mg/d，P<0.05]。药物相关副作用发生率托珠单抗组（22.2%）低于环磷酰胺组（54.5%），差异有统计学意义（P<0.05）。 结论： 托珠单抗治疗大动脉炎有较好疗效，糖皮质激素用量及其副作用少于环磷酰胺。.
Keywords: Interleukin-6; Takayasu; Tocilizumab.