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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1473100
This article is part of the Research Topic Advances in Antigen-Specific Immunotherapies for Autoimmune Disease Management View all 8 articles

Active withdrawal of corticosteroids using tocilizumab and its association with autoantibody profiles in relapsed Takayasu arteritis: a multicentre, single-arm, prospective study (the Ab-TAK study)

Provisionally accepted
Tsuyoshi Shirai Tsuyoshi Shirai 1*TOMONORI ISHII TOMONORI ISHII 2*Soshi Okazaki Soshi Okazaki 1Yuko Shirota Yuko Shirota 2Yusho Ishii Yusho Ishii 1Hiroko Sato Hiroko Sato 1Hiroshi Fujii Hiroshi Fujii 1
  • 1 Tohoku University, Sendai, Japan
  • 2 Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan

The final, formatted version of the article will be published soon.

    The feasibility of corticosteroid withdrawal (CW) for Takayasu arteritis (TAK) remains uncertain.Two autoantibodies (Abs) are identified against endothelial protein C receptor (EPCR) and scavenger receptor class B type 1 (SR-BI) in TAK, determining its three subgroups. This study aimed to evaluate CW using tocilizumab (TCZ) and its association with the Ab profile.This prospective study, lasted for 24 weeks, included patients with relapsed but stable TAK.Scheduled tapering of prednisolone (PSL) was performed with subcutaneous TCZ (CW at week 20). The primary endpoint was the difference in type A remission, defined by CW and the absence of inflammatory signs, according to the Ab profile at week 24.Twenty patients were included and 18 patients with a mean PSL dose of 4.9±2.8 mg/day were analysed. Anti-EPCR Ab-positive (E+), anti-SRBI-positive (S+), and double-negative (DN) groups included four (22.2%), eight (44.4%), and six (33.3%) patients, respectively. At week 24, the mean PSL dose was 2.0±2.7 mg/day. Type A remission was observed in eight patients (44.4%), with significant differences based on the Ab profile: E+ (three patients, 75%), S+ (five patients, 62.5%), and DN (zero patients, 0%) (P=0.018). Besides, age, disease duration, PSL dose, type V arterial lesion, arterial dilation, and C-reactive protein >0.01 mg/dL were identified as risks for CW failure.CW using TCZ was achieved in 44.4% of patients with TAK relapse and was significantly higher in E+ and S+ patients. CW can be a feasible target, and the precise selection of patients is critical.

    Keywords: Autoantibody, corticosteroid, Takayasu Arteritis, tocilizumab, withdrawal

    Received: 30 Jul 2024; Accepted: 09 Dec 2024.

    Copyright: © 2024 Shirai, ISHII, Okazaki, Shirota, Ishii, Sato and Fujii. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Tsuyoshi Shirai, Tohoku University, Sendai, Japan
    TOMONORI ISHII, Tohoku Medical and Pharmaceutical University, Sendai, 981-8558, Miyagi, Japan

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