CERTOLIZUMAB PEGOL IN THE TREATMENT OF TAKAYASU ARTERITIS: THE FIRST EXPERIENCE AND PROSPECTS
Certolizumab pegol (CZP) is the only pegylated biological agent (BA) that does not contain an Fc fragment, which minimizes its transplacental transfer. Takayasu arteritis mostly occurs in reproductive-aged women.Objective: to evaluate the efficacy and safety of CZP used to treat standard immunosuppr...
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doaj-96610ce126c04fd9b57404c7749785df2021-08-02T09:05:51ZrusIMA-PRESS LLCНаучно-практическая ревматология1995-44841995-44922018-07-0156333333810.14412/1995-4484-2018-333-3382364CERTOLIZUMAB PEGOL IN THE TREATMENT OF TAKAYASU ARTERITIS: THE FIRST EXPERIENCE AND PROSPECTSP. I. Novikov0I. O. Smitienko1M. V. Sokolova2S. V. Moiseev3I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaMedical Center K+31 «Petrovskie Vorota» (Petrovsky Arch)M.V. Lomonosov Moscow State UniversityI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia; M.V. Lomonosov Moscow State UniversityCertolizumab pegol (CZP) is the only pegylated biological agent (BA) that does not contain an Fc fragment, which minimizes its transplacental transfer. Takayasu arteritis mostly occurs in reproductive-aged women.Objective: to evaluate the efficacy and safety of CZP used to treat standard immunosuppressive therapy-resistant Takayasu arteritis.Subjects and methods. The retrospective study enrolled 6 female patients aged 18 to 35 years with Takayasu arteritis who received CZP. The median disease duration before BA usage was 66 months (24 to 204 months). The median duration of immunosuppressive therapy prior to CZP treatment was 92 months (14 to 132 months). All the female patients had taken glucocorticoids and methotrexate before and during CZP therapy. Only four patients had received two to five immunosuppressive drugs at different times prior to BA administration. Three patients had previously used other BAs. The disease activity was determined by the National Institute of Health (NIH) criteria. The Indian Takayasu Clinical Activity Score (ITAS2010) was used. The disease activity was recorded in all the patients prior to CZP therapy.Results and discussion. The median duration of CZP treatment was 17 months (6 to 24 months). The median erythrocyte sedimentation rate after CZP usage decreased from 22.5 to 10.5 mm/h; the median C-reactive protein level dropped from 7.8 to 0.39 mg/dl (p<0.05), the median daily dose of prednisolone was reduced from 20 to 8.75 mg (p<0.05). All the patients achieved complete remission an average of 4 months after starting CZP therapy. Three patients were still in remission after 12–24 months. One relapse of the disease was recorded following 24 months. ITAS2010 reduced from 1–4 to 0 in five patients and to 2 in one patient with recurrence. There was a good tolerance in five female patients. The adverse events were herpes labialis in two cases, community-acquired pneumonia in one case, and postoperative abscess in one case too.Conclusion. CZP in Takayasu arteritis was shown to be an effective drug for remission induction and maintenance. The presented results of the first experience in treating this disease with CZP are indicative of its promising further investigation as a steroid-sparing drug in patients with refractory vasculitis. One of the important advantages of CZP is its supposed high safety throughout pregnancy.https://rsp.mediar-press.net/rsp/article/view/2568tnf-α inhibitorstakayasu arteritiscertolizumab pegol |
collection |
DOAJ |
language |
Russian |
format |
Article |
sources |
DOAJ |
author |
P. I. Novikov I. O. Smitienko M. V. Sokolova S. V. Moiseev |
spellingShingle |
P. I. Novikov I. O. Smitienko M. V. Sokolova S. V. Moiseev CERTOLIZUMAB PEGOL IN THE TREATMENT OF TAKAYASU ARTERITIS: THE FIRST EXPERIENCE AND PROSPECTS Научно-практическая ревматология tnf-α inhibitors takayasu arteritis certolizumab pegol |
author_facet |
P. I. Novikov I. O. Smitienko M. V. Sokolova S. V. Moiseev |
author_sort |
P. I. Novikov |
title |
CERTOLIZUMAB PEGOL IN THE TREATMENT OF TAKAYASU ARTERITIS: THE FIRST EXPERIENCE AND PROSPECTS |
title_short |
CERTOLIZUMAB PEGOL IN THE TREATMENT OF TAKAYASU ARTERITIS: THE FIRST EXPERIENCE AND PROSPECTS |
title_full |
CERTOLIZUMAB PEGOL IN THE TREATMENT OF TAKAYASU ARTERITIS: THE FIRST EXPERIENCE AND PROSPECTS |
title_fullStr |
CERTOLIZUMAB PEGOL IN THE TREATMENT OF TAKAYASU ARTERITIS: THE FIRST EXPERIENCE AND PROSPECTS |
title_full_unstemmed |
CERTOLIZUMAB PEGOL IN THE TREATMENT OF TAKAYASU ARTERITIS: THE FIRST EXPERIENCE AND PROSPECTS |
title_sort |
certolizumab pegol in the treatment of takayasu arteritis: the first experience and prospects |
publisher |
IMA-PRESS LLC |
series |
Научно-практическая ревматология |
issn |
1995-4484 1995-4492 |
publishDate |
2018-07-01 |
description |
Certolizumab pegol (CZP) is the only pegylated biological agent (BA) that does not contain an Fc fragment, which minimizes its transplacental transfer. Takayasu arteritis mostly occurs in reproductive-aged women.Objective: to evaluate the efficacy and safety of CZP used to treat standard immunosuppressive therapy-resistant Takayasu arteritis.Subjects and methods. The retrospective study enrolled 6 female patients aged 18 to 35 years with Takayasu arteritis who received CZP. The median disease duration before BA usage was 66 months (24 to 204 months). The median duration of immunosuppressive therapy prior to CZP treatment was 92 months (14 to 132 months). All the female patients had taken glucocorticoids and methotrexate before and during CZP therapy. Only four patients had received two to five immunosuppressive drugs at different times prior to BA administration. Three patients had previously used other BAs. The disease activity was determined by the National Institute of Health (NIH) criteria. The Indian Takayasu Clinical Activity Score (ITAS2010) was used. The disease activity was recorded in all the patients prior to CZP therapy.Results and discussion. The median duration of CZP treatment was 17 months (6 to 24 months). The median erythrocyte sedimentation rate after CZP usage decreased from 22.5 to 10.5 mm/h; the median C-reactive protein level dropped from 7.8 to 0.39 mg/dl (p<0.05), the median daily dose of prednisolone was reduced from 20 to 8.75 mg (p<0.05). All the patients achieved complete remission an average of 4 months after starting CZP therapy. Three patients were still in remission after 12–24 months. One relapse of the disease was recorded following 24 months. ITAS2010 reduced from 1–4 to 0 in five patients and to 2 in one patient with recurrence. There was a good tolerance in five female patients. The adverse events were herpes labialis in two cases, community-acquired pneumonia in one case, and postoperative abscess in one case too.Conclusion. CZP in Takayasu arteritis was shown to be an effective drug for remission induction and maintenance. The presented results of the first experience in treating this disease with CZP are indicative of its promising further investigation as a steroid-sparing drug in patients with refractory vasculitis. One of the important advantages of CZP is its supposed high safety throughout pregnancy. |
topic |
tnf-α inhibitors takayasu arteritis certolizumab pegol |
url |
https://rsp.mediar-press.net/rsp/article/view/2568 |
work_keys_str_mv |
AT pinovikov certolizumabpegolinthetreatmentoftakayasuarteritisthefirstexperienceandprospects AT iosmitienko certolizumabpegolinthetreatmentoftakayasuarteritisthefirstexperienceandprospects AT mvsokolova certolizumabpegolinthetreatmentoftakayasuarteritisthefirstexperienceandprospects AT svmoiseev certolizumabpegolinthetreatmentoftakayasuarteritisthefirstexperienceandprospects |
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