PMC5476896_01
Changes in disease activity, biomarkers, and treatment during anticytokine biologic therapy. Infliximab (IFX) was administered at a dose of 6 mg per kilogram of body weight every four weeks (white bar). Intravenous tocilizumab (TCZ-IV) was administered at a dose of 8 mg per kilogram of body weight every four weeks (black bar), and subcutaneous tocilizumab (TCZ-SC) was administered at a dose of 162 mg per body weight every other week (gray bar). CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; IL-6, interleukin-6; ITAS2010, The Indian Takayasu Activity Score 2010; PSL, prednisolone; PTX3, pentraxin-3.
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fig1
Three months before starting tocilizumab, she again developed claudication in both legs and the left arm (Figure 1).
Changes in the computed tomographic findings of arterial lesions of Takayasu arteritis before and after starting tocilizumab therapy. Contrast-enhanced CT of the descending aorta (the upper), the right femoral artery (the bottom left), and the left femoral artery (the bottom right) was performed. Three months before starting tocilizumab therapy, while on the treatment with infliximab, arterial wall thickening of the femoral arteries was observed (a). After six months of tocilizumab therapy, there was a significant decrease in the wall thickness of the descending aorta and the femoral arteries (b). After 17 months of tocilizumab therapy, there was a further decrease in arterial wall thickness and an increase in the intraluminal diameter of the descending aorta and the femoral arteries (c).
CRIRH2017-4580967.002.jpg
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fig2
CT obtained one year after starting tocilizumab revealed normalization of the appearance of both femoral arteries and improvement of the arterial wall thickening in the lesion of the descending aorta (Figure 2).