Effectiveness of intravenous infliximab versus subcutaneous adalimumab in Takayasu arteritis: a multicentre retrospective study.

OBJECTIVES

In this large multicentre study, we aimed to compare the effectiveness of intravenous infliximab (IFX) vs subcutaneous adalimumab (ADA) in patients with Takayasu arteritis (TAK).

METHODS

We conducted a retrospective multicentre study across referral centres in France, Italy, Spain, Armenia, Israel, Japan, Tunisia, and Russia, analysing biologic targeted therapies in TAK from January 2017 to September 2019.

RESULTS

A total of 135 TAK patients who received ADA (n = 34) or IFX (n = 101) for at least 3 months were included. Baseline demographics, TAK characteristics and concurrent treatments were comparable, except for a higher rate of Numano type V in the ADA group. At 6 months, 71% achieved complete response (NIH <2 with <7.5 mg/day prednisone), including 68% on ADA and 73% on IFX (P = 0.8). The factors associated with complete response to TNF-α inhibitors at 6 months in univariate analysis were age <30 years, tobacco use, vascular signs at the biologic initiation, NIH ≥2, CRP >20 mg/l, a starting dose >20 mg/day of prednisone, but not the use of either IFX or ADA. The cumulative incidence of treatment failure was not significantly different between IFX and ADA patients. During the median [IQR] follow-up of 23 [17, 42] and 48 [25, 99] months in patients who received i.v. IFX and s.c. ADA, respectively, the risk of relapse at 12 months was 10.9% [0, 21.9] and 16.8% [8.64, 24.27], respectively. The overall incidence of revascularizations was not significantly different.

CONCLUSION

In this study, we confirm that IFX and ADA are both effective in TAK, without significant differences in the risk of relapse and revascularizations.