Singh, A and Danda, D and Hussain, S and Najmi, AK and Mathew, A and Goel, R and Lakhan, SE and Tajudheen, B and Antony, B, Efficacy and safety of tocilizumab in treatment of Takayasu arteritis: a systematic review of randomized controlled trials, Modern Rheumatology, 31, (1) pp. 197-204. ISSN 1439-7595 (2020) [Refereed Article]
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Copyright 2020 Japan College of Rheumatology. This is a post-peer-review, pre-copyedit version of an article published in Modern Rheumatology. The final authenticated version is available online at: http://dx.doi.org/10.1080/14397595.2020.1724671
Methods: MEDLINE, Embase, the Cochrane Library, and clinical trial registries were searched from inception to July 2018. We included RCT assessing the efficacy and safety of TCZ versus placebo/other comparators for the treatment of patients with TAK. The risk of bias (RoB) was assessed using Cochrane RoB tool.
Results: 2799 identified articles were screened as per abstract and title; 42 selected full-texts articles were assessed for the potential inclusion. One trial, reported in two publications, comparing subcutaneous TCZ (162 mg/week) versus matching placebo in 36 patients with TAK was included. The relapse-free rate at 24 weeks was 50.6% and 22.9% in TCZ and placebo arm, respectively. The hazard ratio (HR) for time to first relapse was statistically significant in the per-protocol population (HR 0.34 [95.41% CI, 0.11-1.00]; p = .0345), while non-significant in the intention-to-treat population (HR 0.41 [95.41% CI, 0.15-1.10]; p = .0596). The serious adverse events were higher in the placebo arm.
Conclusions: This systematic review finds the existing evidence from RCT on efficacy and safety profile of TCZ in TAK to be promising but limited. Additional evidence is required to draw a stronger conclusion.
|Item Type:||Refereed Article|
|Keywords:||Takayasu arteritis, large vessel vasculitis, systematic review, tocilizumab, meta-analysis|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Clinical sciences|
|Research Field:||Rheumatology and arthritis|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Singh, A (Mr Ambrish Singh)|
|UTAS Author:||Antony, B (Dr Benny Eathakkattu Antony)|
|Web of Science® Times Cited:||3|
|Deposited By:||Menzies Institute for Medical Research|
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