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Publications

Journal Article Ppublish 1 citation

PubMed: 38970381 DOI: 10.1093/rheumatology/keae331

Impact of conventional and biological disease-modifying anti-rheumatic drugs on arterial lesions in Takayasu arteritis.

Rheumatology (Oxford) 64(2):675-681

Authors: Diego Bletry, Louis Meyblum, Kristell Desseaux, Mathieu Vautier, Laurent Chiche, Alexandre Le Joncour, Alban Redheuil, Charles Roux, Patrice Cacoub, Julien Gaudric, Lucie Biard, David Saadoun

Affiliations

  • Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose inflammatoire (CEREMAIA), Sorbonne Universités, Paris, France; INSERM, UMR_S 959, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
  • Department of Interventional Radiology, Sorbonne Universités, Pitié-Salpêtrière University Hospital, Paris, France.
  • Department of Biostatistics and Medical Information, AP-HP Saint-Louis University Hospital, ECSTRRA Team, CRESS UMR 1153, INSERM, University of Paris, Paris, France.
  • Department of Vascular Surgery, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
  • Department of Cardiovascular Imaging, Sorbonne Universités, Pitié-Salpêtrière University Hospital, Paris, France.

Abstract

BACKGROUND

The definition of Takayasu arteritis (TAK) remission and disease activity is still unclear. Vascular imaging is an essential tool for following-up patients. Herein, we aimed to compare the evolution of vascular lesions (i.e. vessel wall thickening and stenosis) under conventional cDMARDs relatively to biological DMARDs (bDMARDs) in TAK patients followed with the same CT angiography modalities.

METHOD

We compared 75 lines of therapy in TAK patients who received cDMARDs (n = 40 lines) and bDMARDs (n = 35 lines) using CT angiography. We established 1-3 main target vessels with vessel wall thickening and/or stenosis. Every targeted vessel had its thickness and its lumen diameter measured at the initiation of immunosuppressive treatment and at 12 months.

RESULTS

We observed an overall reduction in arterial wall thickness in 73% of cases and 31% had >25% relative decrease in the wall thickness. Using a linear mixed effects model, first-line immunosuppressive therapy (P = 0.012) and bDMARDs relatively to cDMARDs (P = 0.026) were independently associated with vessel wall thickness reduction in TAK. Thirty-eight percent of the stenotic vessels had a > 25% relative increase in lumen diameter under immunosuppressive therapy. The relative increase >25% in lumen diameter was noted in 56% vs 17% with bDMARDs compared with cDMARDs.

CONCLUSION

Immunosuppressive treatments can reduce arterial wall thickness and widen lumen diameter in TAK. bDMARDs seem to be more effective than cDMARDs to improve arterial lesions in TAK.

MeSH

Vasculitis, Constriction, Pathologic, Pharmaceutical Preparations, Takayasu Arteritis, Antirheumatic Agents, Angiography, Arteritis, Rheumatic Diseases, Therapeutics, Biological Therapy, Immunosuppression Therapy, Wounds And Injuries